Provider Demographics
NPI:1457603995
Name:WILLIAM STARNES PHD LLC
Entity Type:Organization
Organization Name:WILLIAM STARNES PHD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:STARNES
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:734-612-8887
Mailing Address - Street 1:41133 IVYWOOD LN
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-2628
Mailing Address - Country:US
Mailing Address - Phone:734-612-8887
Mailing Address - Fax:
Practice Address - Street 1:206 S 5TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2229
Practice Address - Country:US
Practice Address - Phone:734-612-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-08
Last Update Date:2012-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012539103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty