Provider Demographics
NPI:1598854614
Name:STRYCZNY, PHILIP A (LPC)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:A
Last Name:STRYCZNY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26934 SOUTHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-1157
Mailing Address - Country:US
Mailing Address - Phone:440-781-1376
Mailing Address - Fax:
Practice Address - Street 1:20525 CENTER RIDGE RD
Practice Address - Street 2:SUITE 520
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3437
Practice Address - Country:US
Practice Address - Phone:440-356-0083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0500989101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH273285026OtherTAX IDENTIFICATION NUMBER