Provider Demographics
NPI:1639139843
Name:STRAKSHUS, GAY (LCSW)
Entity Type:Individual
Prefix:
First Name:GAY
Middle Name:
Last Name:STRAKSHUS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 W SAINT LOUIS ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-4406
Mailing Address - Country:US
Mailing Address - Phone:501-624-1869
Mailing Address - Fax:501-318-9938
Practice Address - Street 1:306 W SAINT LOUIS ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-4406
Practice Address - Country:US
Practice Address - Phone:501-624-1869
Practice Address - Fax:501-318-9938
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1071-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5Y599Medicare ID - Type UnspecifiedPROVIDER NUMBER