Provider Demographics
NPI:1942212238
Name:STAROBIN, CARON TRESINA (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:CARON
Middle Name:TRESINA
Last Name:STAROBIN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17816 WHIMSEY CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-2826
Mailing Address - Country:US
Mailing Address - Phone:301-524-4450
Mailing Address - Fax:
Practice Address - Street 1:18213 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1422
Practice Address - Country:US
Practice Address - Phone:301-524-4450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2021-04-22
Deactivation Date:2021-03-26
Deactivation Code:
Reactivation Date:2021-04-20
Provider Licenses
StateLicense IDTaxonomies
DCLC50077939104100000X
MD12565104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD789608000OtherMAGELLAN
MD254439OtherKEISER
DCA2840145OtherBCBS
MD7855750OtherAETNA
MD407182400Medicaid
MD64472201OtherBCBS