Provider Demographics
NPI:1790274306
Name:THOMAE-STARZYK, REYNA MARIAN (LISW-S)
Entity Type:Individual
Prefix:MRS
First Name:REYNA
Middle Name:MARIAN
Last Name:THOMAE-STARZYK
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:MS
Other - First Name:REYNA
Other - Middle Name:MARIAN
Other - Last Name:THOMAE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSWLSW
Mailing Address - Street 1:25 N CANFIELD NILES RD STE 45
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2308
Mailing Address - Country:US
Mailing Address - Phone:330-501-1545
Mailing Address - Fax:
Practice Address - Street 1:25 N CANFIELD NILES RD STE 45
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2308
Practice Address - Country:US
Practice Address - Phone:330-501-1545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.08002061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical