Provider Demographics
NPI:1508124967
Name:STARR AND CODY COUNSELING, LLC
Entity Type:Organization
Organization Name:STARR AND CODY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:STARR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-201-0408
Mailing Address - Street 1:1820 E 17TH ST STE 230
Mailing Address - Street 2:
Mailing Address - City:IDAHO FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83404-6521
Mailing Address - Country:US
Mailing Address - Phone:208-201-0408
Mailing Address - Fax:
Practice Address - Street 1:1820 E 17TH ST STE 230
Practice Address - Street 2:
Practice Address - City:IDAHO FALLS
Practice Address - State:ID
Practice Address - Zip Code:83404-6521
Practice Address - Country:US
Practice Address - Phone:208-201-0408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-23
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)