MEDICARE: CHASTITY STARR SINK LCMHCA

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	101YM0800X	Mental Health Counselor	A20164	NC

General Provider Information

NPI Number	:	1154165082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHASTITY STARR SINK LCMHCA

Provider Business Mailing Address
First Line	:	835 HISTORIAN ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27603-3490
Country	:	US
Telephone Number	:	562-787-2464
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 YORKSHIRE ST STE D
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28803-2768
Country	:	US
Telephone Number	:	828-724-7166
Fax Number	:	828-724-7165

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

Provider Enumeration Date	:	06/24/2024
Last Update Date	:	06/26/2024

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