Provider Demographics
NPI:1790931699
Name:STARR, SHARON B (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:B
Last Name:STARR
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 1:116 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-4226
Mailing Address - Country:US
Mailing Address - Phone:860-575-2614
Mailing Address - Fax:203-265-3651
Practice Address - Street 1:116 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-4226
Practice Address - Country:US
Practice Address - Phone:860-575-2614
Practice Address - Fax:203-265-3651
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0063951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical