Provider Demographics
NPI:1063795839
Name:STRIKER, JODY ANNE (LCPC)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:ANNE
Last Name:STRIKER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:ANNE
Other - Last Name:PEARCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:2829 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61101-4162
Mailing Address - Country:US
Mailing Address - Phone:815-962-0633
Mailing Address - Fax:
Practice Address - Street 1:2720 GLENWOOD CT
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61101-3507
Practice Address - Country:US
Practice Address - Phone:815-962-0633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007220101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional