Provider Demographics
NPI:1013574110
Name:ASROUCH, STARR S
Entity type:Individual
Prefix:
First Name:STARR
Middle Name:S
Last Name:ASROUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:STARR
Other - Middle Name:S
Other - Last Name:LITTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:839 AVATAR DR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-6823
Mailing Address - Country:US
Mailing Address - Phone:904-495-5650
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 6038
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-0038
Practice Address - Country:US
Practice Address - Phone:757-263-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-23
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool