Provider Demographics
NPI:1760073134
Name:STRICKLAND, WANDA (LPC)
Entity Type:Individual
Prefix:
First Name:WANDA
Middle Name:
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:WANDA
Other - Middle Name:SUE
Other - Last Name:MERRITT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 362
Mailing Address - Street 2:
Mailing Address - City:TIGER
Mailing Address - State:GA
Mailing Address - Zip Code:30576-0362
Mailing Address - Country:US
Mailing Address - Phone:706-970-7748
Mailing Address - Fax:
Practice Address - Street 1:132 LINCOLN LN
Practice Address - Street 2:
Practice Address - City:TIGER
Practice Address - State:GA
Practice Address - Zip Code:30576-2517
Practice Address - Country:US
Practice Address - Phone:706-970-7748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-28
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC012549101Y00000X
GAAPC006317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor