Provider Demographics
NPI:1063025922
Name:STAR, EMILY RACHEL (LMSW)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:RACHEL
Last Name:STAR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 SILVER SPRING AVE APT 210A
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4610
Mailing Address - Country:US
Mailing Address - Phone:858-752-1695
Mailing Address - Fax:
Practice Address - Street 1:415 SILVER SPRING AVE APT 210A
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4610
Practice Address - Country:US
Practice Address - Phone:858-752-1695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD263101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical