Provider Demographics
NPI:1457487662
Name:STARBUCK, JEFFREY CORBETT (MSW)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:CORBETT
Last Name:STARBUCK
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 MULBERRY ROW
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-2838
Mailing Address - Country:US
Mailing Address - Phone:609-759-0108
Mailing Address - Fax:
Practice Address - Street 1:32 MULBERRY ROW
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-2838
Practice Address - Country:US
Practice Address - Phone:609-683-1544
Practice Address - Fax:609-683-7152
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-24
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJLCSW #44SC004864001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
03826000OtherMBC PROVIDER #
NJ44SC00486400OtherLCSW, NEW JERSEY
5166311OtherAETNA PROVIDER #
IP097379OtherMAGELLAN (MBH) PROVIDER #
NYPR027175-1OtherLCSW, NEW YORK STATE
0064500OtherGHI PROVIDER #
9082278OtherPHCS PIN
104158OtherMHN PROVIDER #
145195OtherVALUE OPTIONS PROVIDER #
IP097379OtherMAGELLAN (MBH) PROVIDER #