Provider Demographics
NPI:1972712164
Name:SUSAN J STRICKLAND LLC
Entity Type:Organization
Organization Name:SUSAN J STRICKLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCSW, MT-BC
Authorized Official - Phone:850-385-9755
Mailing Address - Street 1:PO BOX 20162
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32316-0162
Mailing Address - Country:US
Mailing Address - Phone:850-385-9755
Mailing Address - Fax:850-386-4583
Practice Address - Street 1:2014 DELTA BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-4853
Practice Address - Country:US
Practice Address - Phone:850-385-9755
Practice Address - Fax:850-386-4583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW85611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL7186922OtherAETNA
FL600251705OtherMAGELLAN
FLZ139HOtherBLUECROSS BLUESHIELD
FLZ139HOtherBLUECROSS BLUESHIELD
FL=========OtherTRICARE