Provider Demographics
NPI:1487849931
Name:ARMSTRONG, STARLETT RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:STARLETT
Middle Name:RENEE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 KIRBYWOOD CV
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38305-1801
Mailing Address - Country:US
Mailing Address - Phone:731-444-1344
Mailing Address - Fax:
Practice Address - Street 1:24 KIRBYWOOD CV
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1801
Practice Address - Country:US
Practice Address - Phone:731-444-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN71611041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ074863Medicaid