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General NPI Number Information
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NPI Number | 1912353228
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Entity Type | Organization
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Legal Business Name | STARKS COUNSELING AND CONSULTATION SERVICES
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Dates
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Enumeration Date | 05/05/2016
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Last Update Date | 05/05/2016
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Provider Practice Location Address
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Address Line | 175 S 3RD ST 200
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City | COLUMBUS
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State | OH
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Zip | 43215-5134
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Country | US
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Telephone | 614-484-0919
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Fax |
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Provider Business Mailing Address
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Address Line | 175 S 3RD ST 200
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City | COLUMBUS
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State | OH
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Zip | 43215-5134
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Country | US
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Telephone | 614-484-0919
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Fax |
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MS. STEPHANIE KIMBERLY STARKS
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Credential | LISW
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Telephone | 614-484-0919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I 1600116
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License Number State | OH
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