Provider Demographics
NPI:1275964710
Name:STARR, LYNDA SEAGRAVES
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:SEAGRAVES
Last Name:STARR
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LYNDA
Other - Middle Name:SEAGRAVES
Other - Last Name:STARR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:360 CAMPBELL AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-3625
Mailing Address - Country:US
Mailing Address - Phone:540-563-5316
Mailing Address - Fax:540-563-5254
Practice Address - Street 1:360 CAMPBELL AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-3625
Practice Address - Country:US
Practice Address - Phone:540-563-5316
Practice Address - Fax:540-563-5254
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005669101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional