Provider Demographics
NPI:1285993808
Name:STRAYER, JENNIFER JUNE (LCSW)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JUNE
Last Name:STRAYER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:JUNE STRAYER
Other - Last Name:DYAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1920 MAIN ST
Mailing Address - Street 2:#223
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72114-2872
Mailing Address - Country:US
Mailing Address - Phone:501-313-1507
Mailing Address - Fax:
Practice Address - Street 1:1920 MAIN ST
Practice Address - Street 2:#223
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-2872
Practice Address - Country:US
Practice Address - Phone:501-313-1507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2408-M1041C0700X
AR3816-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical