Healthcare Provider Details

I. General information

NPI: 1558412445
Provider Name (Legal Business Name): MATTHEW HARVEY STRICKLIN JR. MDIV, MSED, LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 11/09/2024
Certification Date: 11/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5936 WOODSPOINT DR
MILFORD OH
45150-2157
US

IV. Provider business mailing address

5936 WOODSPOINT DR
MILFORD OH
45150-2157
US

V. Phone/Fax

Practice location:
  • Phone: 513-535-6053
  • Fax:
Mailing address:
  • Phone: 513-535-6053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCERTIFICATION 050075
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE. 0700182
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE.0700182-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: