Provider Demographics
NPI:1053615765
Name:STARRITT, JACLYN (PHD)
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:
Last Name:STARRITT
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 1:300 ASHVILLE AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8682
Mailing Address - Country:US
Mailing Address - Phone:919-415-1793
Mailing Address - Fax:
Practice Address - Street 1:300 ASHVILLE AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8682
Practice Address - Country:US
Practice Address - Phone:919-415-1793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4292103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist