Provider Demographics
NPI:1851575203
Name:STRACHAN, IAN (LMSW)
Entity Type:Individual
Prefix:MR
First Name:IAN
Middle Name:
Last Name:STRACHAN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:MR
Other - First Name:IAN
Other - Middle Name:
Other - Last Name:STRACHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:PO BOX 706
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-0706
Mailing Address - Country:US
Mailing Address - Phone:631-555-1000
Mailing Address - Fax:
Practice Address - Street 1:681 CLARKSON AVENUE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:631-555-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072940-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker