Provider Demographics
NPI:1194533752
Name:STREICH, CALLIE BRYN (LPC)
Entity type:Individual
Prefix:
First Name:CALLIE
Middle Name:BRYN
Last Name:STREICH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 CLAYWOODS DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-7408
Mailing Address - Country:US
Mailing Address - Phone:816-719-8972
Mailing Address - Fax:
Practice Address - Street 1:200 NE MISSOURI RD STE 300
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-4724
Practice Address - Country:US
Practice Address - Phone:816-839-9426
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022016634101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty