Basic Information
| Provider Information | |||||||||
| NPI: | 1417131442 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STRAUSS | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | LEIGH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 508 FULTON ST # 152 | ||||||||
| Address2: | DURHAM VA MEDICAL CENTER | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277053875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192860411 | ||||||||
| FaxNumber: | 9194165832 | ||||||||
| Practice Location | |||||||||
| Address1: | 508 FULTON ST # 152 | ||||||||
| Address2: | DURHAM VA MEDICAL CENTER | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277053875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192860411 | ||||||||
| FaxNumber: | 9194165832 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2007 | ||||||||
| LastUpdateDate: | 12/27/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 2842 | NC | N | Behavioral Health & Social Service Providers | Psychologist | 103TB0200X | 2842 | NC | N | Behavioral Health & Social Service Providers | Psychologist | Cognitive & Behavioral | 103TC0700X | 2842 | NC | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical | 103TH0100X | 2842 | NC | N | Behavioral Health & Social Service Providers | Psychologist | Health Service | 103TP2701X | 2842 | NC | N | Behavioral Health & Social Service Providers | Psychologist | Group Psychotherapy |
No ID Information.