Provider Demographics
NPI:1497832281
Name:QUALTER, STARLEE N (LCSW)
Entity Type:Individual
Prefix:
First Name:STARLEE
Middle Name:N
Last Name:QUALTER
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 1:97 VILLAGE GRN
Mailing Address - Street 2:
Mailing Address - City:BARDONIA
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2040
Mailing Address - Country:US
Mailing Address - Phone:845-323-2425
Mailing Address - Fax:
Practice Address - Street 1:20 SQUADRON BLVD
Practice Address - Street 2:SUITE 210 A
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5200
Practice Address - Country:US
Practice Address - Phone:845-323-2425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0479841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical