1508018102 NPI number — MRS. YVONNE MARIE STARNER LCSW

Table of content: MRS. YVONNE MARIE STARNER LCSW (NPI 1508018102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508018102 NPI number — MRS. YVONNE MARIE STARNER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STARNER
Provider First Name:
YVONNE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OGONOWSKI
Provider Other First Name:
YVONNE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1508018102
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
85 S WEST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOMER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13077-1542
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-753-3797
Provider Business Mailing Address Fax Number:
607-753-6677

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 TECHNOLOGY PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOMER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13077-1526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-753-3774
Provider Business Practice Location Address Fax Number:
607-753-3947
Provider Enumeration Date:
10/15/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  090273 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07186414 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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