Healthcare Provider Details

I. General information

NPI: 1679228753
Provider Name (Legal Business Name): SALLY STARR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35273 BALMORAL DR
LOCUST GROVE VA
22508-3106
US

IV. Provider business mailing address

35273 BALMORAL DR
LOCUST GROVE VA
22508-3106
US

V. Phone/Fax

Practice location:
  • Phone: 703-688-3710
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701010578
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: