Provider Demographics
NPI:1942861463
Name:STARLING, NATALIE ROSE (PHD)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:ROSE
Last Name:STARLING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-0071
Mailing Address - Country:US
Mailing Address - Phone:860-336-9910
Mailing Address - Fax:
Practice Address - Street 1:76 WESTBURY PARK RD STE 306E
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2779
Practice Address - Country:US
Practice Address - Phone:860-336-9910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003765103T00000X
CT262103K00000X
CTC062016002529103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool