Basic Information
| Provider Information | |||||||||
| NPI: | 1083371066 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRICKLAND | ||||||||
| FirstName: | CHRISTIAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1445 GENEVA LOOP APT 12B | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112392414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3478167737 | ||||||||
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| Practice Location | |||||||||
| Address1: | 191 JORALEMON ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112014306 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187226000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2021 | ||||||||
| LastUpdateDate: | 11/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.