Provider Demographics
NPI:1679198410
Name:STRICKLAND, LORRI MICHELLE (CAC I)
Entity Type:Individual
Prefix:
First Name:LORRI
Middle Name:MICHELLE
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:CAC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 HARVEYTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:GA
Mailing Address - Zip Code:31321-7012
Mailing Address - Country:US
Mailing Address - Phone:912-515-5026
Mailing Address - Fax:912-785-2008
Practice Address - Street 1:1040 US HWY 280 W
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:GA
Practice Address - Zip Code:31321
Practice Address - Country:US
Practice Address - Phone:912-515-5026
Practice Address - Fax:912-785-2008
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)