Provider Demographics
NPI:1669977237
Name:STRATEGIC THERAPY ASSOCIATES, INC.
Entity type:Organization
Organization Name:STRATEGIC THERAPY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY ASSURANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-473-6955
Mailing Address - Street 1:108 DUNCRAIG DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-3335
Mailing Address - Country:US
Mailing Address - Phone:434-473-6955
Mailing Address - Fax:
Practice Address - Street 1:201 N MAIN ST STE 2204
Practice Address - Street 2:
Practice Address - City:FARMVILLE
Practice Address - State:VA
Practice Address - Zip Code:23901-1300
Practice Address - Country:US
Practice Address - Phone:434-237-9450
Practice Address - Fax:434-237-9454
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STRATEGIC THERAPY ASSOCIATES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-03-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01405001251S00000X
VA01403001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health