Provider Demographics
NPI:1154785228
Name:KEIP-STRAUSBAUGH, ERIN LYNN (LMHC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:LYNN
Last Name:KEIP-STRAUSBAUGH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LYNN
Other - Last Name:BACHERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 24
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:FL
Mailing Address - Zip Code:32462-0024
Mailing Address - Country:US
Mailing Address - Phone:570-810-9505
Mailing Address - Fax:850-248-2468
Practice Address - Street 1:2549 DAVIDS RD
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:FL
Practice Address - Zip Code:32462-3178
Practice Address - Country:US
Practice Address - Phone:570-810-9505
Practice Address - Fax:850-248-2469
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12536101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health