Provider Demographics
NPI:1659644342
Name:STARFISH SERVICES LLC
Entity Type:Organization
Organization Name:STARFISH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:STENDER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LICSW
Authorized Official - Phone:612-567-4654
Mailing Address - Street 1:PO BOX 954
Mailing Address - Street 2:
Mailing Address - City:CHANHASSEN
Mailing Address - State:MN
Mailing Address - Zip Code:55317-0954
Mailing Address - Country:US
Mailing Address - Phone:612-567-4654
Mailing Address - Fax:
Practice Address - Street 1:600 W 78TH ST
Practice Address - Street 2:SUITE 220A
Practice Address - City:CHANHASSEN
Practice Address - State:MN
Practice Address - Zip Code:55317-9585
Practice Address - Country:US
Practice Address - Phone:612-567-4654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-12
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN104041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty