Healthcare Provider Details

I. General information

NPI: 1457161028
Provider Name (Legal Business Name): SYDNEY STARR
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: CHARLIE STARR

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 E MAIN ST FL 3B
COLUMBUS OH
43215-5377
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 844-622-5564
  • Fax:
Mailing address:
  • Phone: 614-722-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.2614061
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: