Provider Demographics
NPI:1679683593
Name:HORNUNG-STARR, JEAN (MSW)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:
Last Name:HORNUNG-STARR
Suffix:
Gender:F
Credentials:MSW
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 40722
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85274-0722
Mailing Address - Country:US
Mailing Address - Phone:480-350-3000
Mailing Address - Fax:480-345-1973
Practice Address - Street 1:2815 S ALMA SCHOOL RD
Practice Address - Street 2:SUITE 105
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-4031
Practice Address - Country:US
Practice Address - Phone:480-350-3000
Practice Address - Fax:480-345-1973
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-39701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical