Provider Demographics
NPI:1932460094
Name:STRICKLEN, MONICA MARIE
Entity Type:Individual
Prefix:MRS
First Name:MONICA
Middle Name:MARIE
Last Name:STRICKLEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 PINEY POINT LN
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-4110
Mailing Address - Country:US
Mailing Address - Phone:678-796-6524
Mailing Address - Fax:414-815-0428
Practice Address - Street 1:2315 PINEY POINT LN
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-4110
Practice Address - Country:US
Practice Address - Phone:678-796-6524
Practice Address - Fax:414-815-0428
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC009719101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor