Provider Demographics
NPI:1619314598
Name:STARNES, SHERRY B (MSP, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHERRY
Middle Name:B
Last Name:STARNES
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 FOSTER STREET
Mailing Address - Street 2:COWPENS ELEMENTARY SCHOOL
Mailing Address - City:COWPENS
Mailing Address - State:SC
Mailing Address - Zip Code:29330
Mailing Address - Country:US
Mailing Address - Phone:864-279-6300
Mailing Address - Fax:864-279-6310
Practice Address - Street 1:341 FOSTER STREET
Practice Address - Street 2:
Practice Address - City:COWPENS
Practice Address - State:SC
Practice Address - Zip Code:29330-0341
Practice Address - Country:US
Practice Address - Phone:864-279-6300
Practice Address - Fax:864-279-6310
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1070235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1070Medicaid