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General NPI Number Information
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NPI Number | 1023343704
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Entity Type | Organization
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Legal Business Name | SAM STARR, MSW, LCSW, LLC
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Dates
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Enumeration Date | 10/13/2009
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 836 FARMINGTON AVE STE 223
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1505
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Country | US
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Telephone | 860-916-2908
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Fax |
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Provider Business Mailing Address
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Address Line | 72 GLENWOOD RD
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City | WEST HARTFORD
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State | CT
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Zip | 06107-1507
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Country | US
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Telephone | 860-916-2908
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMUEL E STARR
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Credential |
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Telephone | 860-916-2908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 004467
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License Number State | CT
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