Provider Demographics
NPI:1790965275
Name:STRICKLAND, JENNIFER RAE (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RAE
Last Name:STRICKLAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 W CHESTERFIELD BLVD STE D102
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-8648
Mailing Address - Country:US
Mailing Address - Phone:417-862-2273
Mailing Address - Fax:
Practice Address - Street 1:2124 W CHESTERFIELD BLVD STE D102
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-8648
Practice Address - Country:US
Practice Address - Phone:417-862-2273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2003030736101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional