MEDICARE: STRYKER BEHAVIORAL HEALTH, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1376955138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRYKER BEHAVIORAL HEALTH, INC

Provider Business Mailing Address
First Line	:	2451 CUMBERLAND PKWY SE STE 3427
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30339-6136
Country	:	US
Telephone Number	:	678-371-7189
Fax Number	:	239-747-7177

Provider Business Practice Location Address
First Line	:	4560 VINSETTA AVE
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-4654
Country	:	US
Telephone Number	:	678-371-7189
Fax Number	:	239-747-7177

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	MR. ROBERT ALAN STRYKER
Credential	:	LCSW, MCAP, ACHP-SW
Telephone Number	:	678-371-7189

Provider Enumeration Date	:	05/28/2014
Last Update Date	:	06/25/2024

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