Healthcare Provider Details

I. General information

NPI: 1124373188
Provider Name (Legal Business Name): JACQUELYN MONIQUE STRAIT PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2012
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GALLERIA BLVD STE 1900
METAIRIE LA
70001-7553
US

IV. Provider business mailing address

529 CAMPBELL DR
LEAGUE CITY TX
77573-3154
US

V. Phone/Fax

Practice location:
  • Phone: 281-330-2750
  • Fax: 281-754-4985
Mailing address:
  • Phone: 832-481-6157
  • Fax: 281-754-4985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number36133
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY-2024-0057
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License NumberPSY-2026-0015
License Number StateNM
# 4
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number350927
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: