Individual
JEREMY STARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW LGSW
Contact information
Practice address
1 KENTON DR STE 200, CHARLESTON, WV 25311-1256
(304) 460-5123
Mailing address
1 KENTON DR STE 200, CHARLESTON, WV 25311-1256
(304) 460-5123
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00946362
WV
1041C0700X
Clinical Social Worker
BP00946362
WV
Other
Enumeration date
07/19/2023
Last updated
04/10/2025
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