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Organization
STARLA R. SHOLL, LCSW, PC
Active
Organization
STARLA R. SHOLL, LCSW, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STARLA RAE SHOLL LCSW (PRESIDENT)
(773) 878-5809
Entity
Organization
Contact information
Practice address
5349 N WINTHROP AVE # 2, CHICAGO, IL 60640-2309
(773) 878-5809
Mailing address
5349 N WINTHROP AVE # 2, CHICAGO, IL 60640-2309
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1627237
BLUE CROSS & BLUE SHIELD
—
Enumeration date
09/25/2007
Last updated
09/25/2007
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