Provider Demographics
NPI:1578600599
Name:STRICKLAND, ALETA EDE (EDS)
Entity Type:Individual
Prefix:MS
First Name:ALETA
Middle Name:EDE
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2189
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:VA
Mailing Address - Zip Code:23093-3689
Mailing Address - Country:US
Mailing Address - Phone:540-223-0837
Mailing Address - Fax:
Practice Address - Street 1:115 JEFFERSON HWY
Practice Address - Street 2:SAGE BUILDING, SUITE J
Practice Address - City:LOUISA
Practice Address - State:VA
Practice Address - Zip Code:23093-6563
Practice Address - Country:US
Practice Address - Phone:540-223-0837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0803000218103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA248114OtherANTHEM PROVIDER NUMBER