| Star City Therapy Services | |
|
4220 Cypress Park Dr Ste B Roanoke VA 24018-8403 | |
| (540) 772-1872 | |
| Not Available |
| Full Name | Star City Therapy Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 4220 Cypress Park Dr Ste B, Roanoke, Virginia |
| Authorized Official Name and Position | Holly Mccloud (CEO) |
| Authorized Official Contact | 5402062865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Star City Therapy Services 3618 Brambleton Ave Ste D Roanoke VA 24018-3659 Ph: (540) 206-8265 | Star City Therapy Services 4220 Cypress Park Dr Ste B Roanoke VA 24018-8403 Ph: (540) 772-1872 |
| NPI Number | 1629610035 |
|---|---|
| Provider Enumeration Date | 10/17/2019 |
| Last Update Date | 09/26/2023 |
| Certification Date | 09/26/2023 |
| Medicare PECOS PAC ID | 2062866874 |
|---|---|
| Medicare Enrollment ID | O20230928000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629610035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
| Provider Name | Emily Uribe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619505328 PECOS PAC ID: 5799139515 Enrollment ID: I20230928000169 |
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