Provider Demographics
NPI:1639490717
Name:STARNES, CYNTHIA M (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:M
Last Name:STARNES
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:PO BOX 453
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-0453
Mailing Address - Country:US
Mailing Address - Phone:434-327-6262
Mailing Address - Fax:434-202-7672
Practice Address - Street 1:302 HICKMAN RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-3572
Practice Address - Country:US
Practice Address - Phone:434-327-6262
Practice Address - Fax:434-202-7672
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-12
Last Update Date:2012-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040073501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA11978207OtherCAQH