Provider Demographics
NPI:1649579459
Name:STRICKLAND, JERRY L (LPC)
Entity type:Individual
Prefix:MR
First Name:JERRY
Middle Name:L
Last Name:STRICKLAND
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8229 CANOLA BND
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-6467
Mailing Address - Country:US
Mailing Address - Phone:512-917-1219
Mailing Address - Fax:
Practice Address - Street 1:8229 CANOLA BND
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-6467
Practice Address - Country:US
Practice Address - Phone:512-917-1219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX64137101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional