Provider Demographics
NPI:1285403279
Name:STARR, JEAN EASTON (LCSW-C)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:EASTON
Last Name:STARR
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 APPLE TREE LN
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-4416
Mailing Address - Country:US
Mailing Address - Phone:301-602-8430
Mailing Address - Fax:
Practice Address - Street 1:2207 APPLE TREE LN
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905-4416
Practice Address - Country:US
Practice Address - Phone:301-602-8430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD049501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical