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General NPI Number Information
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NPI Number | 1568869832
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Entity Type | Organization
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Legal Business Name | STARR BEHAVIORAL SERVICES CORP
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Dates
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Enumeration Date | 12/02/2014
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 5457 TWIN KNOLLS RD STE 300
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City | COLUMBIA
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State | MD
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Zip | 21045-3296
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Country | US
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Telephone | 443-955-8683
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Fax | 410-531-5085
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Provider Business Mailing Address
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Address Line | 5457 TWIN KNOLLS RD STE 300
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City | COLUMBIA
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State | MD
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Zip | 21045-3296
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Country | US
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Telephone | 443-955-8683
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Fax | 410-531-5085
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Authorized Official
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Title or Position | PSYCHIATRIST
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Name | MISS XIUDI FAN
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Credential | M. D.
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Telephone | 443-955-8683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0059727
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License Number State | MD
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