Healthcare Provider Details

I. General information

NPI: 1124948906
Provider Name (Legal Business Name): S.T.A.R. THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 E KANSAS ST STE 102
LIBERTY MO
64068-2355
US

IV. Provider business mailing address

214 E KANSAS ST STE 102
LIBERTY MO
64068-2355
US

V. Phone/Fax

Practice location:
  • Phone: 816-514-0781
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: SARAH EDELMAN-DOLAN
Title or Position: PROVIDER/OWNER
Credential: LCSW
Phone: 816-514-0781