Healthcare Provider Details

I. General information

NPI: 1285271791
Provider Name (Legal Business Name): CARLA STARR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2019
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date: 04/04/2022
Reactivation Date: 07/13/2022

III. Provider practice location address

909 SAINT JOSEPH ST STE 201
RAPID CITY SD
57701-3304
US

IV. Provider business mailing address

3213 W MAIN ST # 259
RAPID CITY SD
57702-2314
US

V. Phone/Fax

Practice location:
  • Phone: 605-608-2255
  • Fax:
Mailing address:
  • Phone: 605-608-2255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7130
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number136916
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number091916
License Number StateNY
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5242
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: