Provider Demographics
NPI:1417494923
Name:STARR, DEBRA POMROY
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:POMROY
Last Name:STARR
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:DEBRA
Other - Middle Name:POMROY
Other - Last Name:LUNDERGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSCSW, LCSW, RPT
Mailing Address - Street 1:833 W 51ST ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2372
Mailing Address - Country:US
Mailing Address - Phone:816-519-3003
Mailing Address - Fax:816-753-5755
Practice Address - Street 1:833 W 51ST ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-2372
Practice Address - Country:US
Practice Address - Phone:816-519-3003
Practice Address - Fax:816-753-5755
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-22
Last Update Date:2017-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46361041C0700X
MO20160056501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical