Provider Demographics
NPI:1881403210
Name:STARKS, NATHAN SHERREL SR (MSW)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:SHERREL
Last Name:STARKS
Suffix:SR
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 DEER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-7105
Mailing Address - Country:US
Mailing Address - Phone:803-315-0808
Mailing Address - Fax:
Practice Address - Street 1:127 DEER CREEK DR
Practice Address - Street 2:
Practice Address - City:BLYTHEWOOD
Practice Address - State:SC
Practice Address - Zip Code:29016-7105
Practice Address - Country:US
Practice Address - Phone:803-315-0808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker