Provider Demographics
NPI:1699772517
Name:STRICKER, GEORGE (PHD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:
Last Name:STRICKER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 N LEISURE WORLD BLVD
Mailing Address - Street 2:#1021
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-8341
Mailing Address - Country:US
Mailing Address - Phone:301-598-0969
Mailing Address - Fax:
Practice Address - Street 1:3100 N LEISURE WORLD BLVD
Practice Address - Street 2:#1021
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-8341
Practice Address - Country:US
Practice Address - Phone:301-598-0969
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04079103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV18611Medicare ID - Type Unspecified