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NPI Code Detail

MEDICARE: HEATHER RENEE STARKS LCSW

MEDICARE:   HEATHER RENEE STARKS  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
11041C0700XClinical Social Worker072995-1NY

General Provider Information

NPI Number : 1285015040
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER RENEE STARKS LCSW
Provider Business Mailing Address
First Line : 2300 EAST AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14610-2564
Country : US
Telephone Number : 585-500-9420
Fax Number :
Provider Business Practice Location Address
First Line : 2300 EAST AVE
Second Line :
City : ROCHESTER
State : NY
Zip : 14610-2564
Country : US
Telephone Number : 585-500-9420
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2015
Last Update Date : 02/06/2023

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Directions to “ HEATHER RENEE STARKS LCSW” Practice Location

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