Provider Demographics
NPI:1033923073
Name:STARKS, KIMBERLY FAYE (LGPC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:FAYE
Last Name:STARKS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3022 GATEHOUSE CT
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-3025
Mailing Address - Country:US
Mailing Address - Phone:301-873-7330
Mailing Address - Fax:
Practice Address - Street 1:1629 K ST NW STE 300
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-1631
Practice Address - Country:US
Practice Address - Phone:202-998-6956
Practice Address - Fax:202-796-3997
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-01
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty