Healthcare Provider Details

I. General information

NPI: 1881365120
Provider Name (Legal Business Name): TARISHA STARKS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/27/2021
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 NW BRIARCLIFF PKWY STE 228
KANSAS CITY MO
64116-1905
US

IV. Provider business mailing address

1112 CLEVELAND AVE
KANSAS CITY MO
64127-1539
US

V. Phone/Fax

Practice location:
  • Phone: 913-585-4408
  • Fax:
Mailing address:
  • Phone: 816-217-9432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2021035029
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: