MEDICARE: WILLIAM K STARRETT LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	SW3609	FL

General Provider Information

NPI Number	:	1134272123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM K STARRETT LCSW

Provider Business Mailing Address
First Line	:	4835 27TH ST W STE 125
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-1759
Country	:	US
Telephone Number	:	941-753-0064
Fax Number	:	941-753-2977

Provider Business Practice Location Address
First Line	:	2722 MANATEE AVE W
Second Line	:	STE 4
City	:	BRADENTON
State	:	FL
Zip	:	34205-4945
Country	:	US
Telephone Number	:	941-742-6673
Fax Number	:	941-746-2501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2007
Last Update Date	:	09/03/2019

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