Provider Demographics
NPI:1386163038
Name:STAIRIKER, BRIANA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:BRIANA
Middle Name:
Last Name:STAIRIKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:BRIANA
Other - Middle Name:
Other - Last Name:GOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:2410 HANNUM AVE
Mailing Address - Street 2:
Mailing Address - City:HOLMES
Mailing Address - State:PA
Mailing Address - Zip Code:19043-1309
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 KEYSTONE AVE
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-1129
Practice Address - Country:US
Practice Address - Phone:610-284-0200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-13
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0196411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical