Provider Demographics
NPI:1568619922
Name:JAMES DALE STREIFF
Entity type:Organization
Organization Name:JAMES DALE STREIFF
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:STREIFF
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CAC/CCS, CCDP
Authorized Official - Phone:717-507-1386
Mailing Address - Street 1:756 CUMBERLAND ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-5268
Mailing Address - Country:US
Mailing Address - Phone:717-507-1386
Mailing Address - Fax:717-273-9247
Practice Address - Street 1:756 CUMBERLAND ST
Practice Address - Street 2:SUITE 3
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5268
Practice Address - Country:US
Practice Address - Phone:717-507-1386
Practice Address - Fax:717-273-9247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA387022251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health