Provider Demographics
NPI:1245662246
Name:STRICKLAND, WARREN ADRIAN (LPC)
Entity type:Individual
Prefix:MR
First Name:WARREN
Middle Name:ADRIAN
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:MR
Other - First Name:ADRIAN
Other - Middle Name:
Other - Last Name:STRICKLAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:415 S 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-7246
Mailing Address - Country:US
Mailing Address - Phone:601-261-1650
Mailing Address - Fax:601-579-5240
Practice Address - Street 1:102 MEDICAL PARK STE B
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-9080
Practice Address - Country:US
Practice Address - Phone:601-261-1650
Practice Address - Fax:601-545-1740
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-01
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1602101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09679291Medicaid