Provider Demographics
NPI:1366115693
Name:KING STRICKLAND, STEPHANIE LEE (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LEE
Last Name:KING STRICKLAND
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-1937
Mailing Address - Country:US
Mailing Address - Phone:304-534-0049
Mailing Address - Fax:
Practice Address - Street 1:14 E GRAFTON RD STE C
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-4465
Practice Address - Country:US
Practice Address - Phone:681-758-9311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVCP009449451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical