Provider Demographics
NPI:1033329503
Name:STARKES, GAYLE BRADLEY (MSW-LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:BRADLEY
Last Name:STARKES
Suffix:
Gender:F
Credentials:MSW-LCSW-C
Other - Prefix:
Other - First Name:GAYLE
Other - Middle Name:B
Other - Last Name:STARKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5850 WATERLOO RD STE 230
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-1943
Mailing Address - Country:US
Mailing Address - Phone:301-757-2077
Mailing Address - Fax:
Practice Address - Street 1:5850 WATERLOO RD STE 230
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1943
Practice Address - Country:US
Practice Address - Phone:410-757-2077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC302507101YM0800X
VA0904003257101YM0800X
MD11165101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health