Healthcare Provider Details

I. General information

NPI: 1841646387
Provider Name (Legal Business Name): ANNE LOUISE STARR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 SPRING ARBOR RD
JACKSON MI
49203-8605
US

IV. Provider business mailing address

52 DICKENS RD
SPRING ARBOR MI
49283-8701
US

V. Phone/Fax

Practice location:
  • Phone: 517-392-2662
  • Fax: 517-841-8804
Mailing address:
  • Phone: 517-392-2662
  • Fax: 517-841-8804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401011505
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberIF0000000281580
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: