Provider Demographics
NPI:1952999419
Name:RODDY, STARLEN (LPC)
Entity Type:Individual
Prefix:MR
First Name:STARLEN
Middle Name:
Last Name:RODDY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3990 COUNTY ROAD 269
Mailing Address - Street 2:
Mailing Address - City:OGLESBY
Mailing Address - State:TX
Mailing Address - Zip Code:76561-1549
Mailing Address - Country:US
Mailing Address - Phone:254-289-8715
Mailing Address - Fax:
Practice Address - Street 1:3990 COUNTY ROAD 269
Practice Address - Street 2:
Practice Address - City:OGLESBY
Practice Address - State:TX
Practice Address - Zip Code:76561-1549
Practice Address - Country:US
Practice Address - Phone:254-289-8715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77059101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional