MEDICARE: MRS. STEPHANIE M STARKS-LOVELADY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency		OH
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1063984375
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE M STARKS-LOVELADY

Provider Business Mailing Address
First Line	:	1375 WAGGONER RD
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-1249
Country	:	US
Telephone Number	:	614-746-0596
Fax Number	:

Provider Business Practice Location Address
First Line	:	1375 WAGGONER RD
Second Line	:
City	:	REYNOLDSBURG
State	:	OH
Zip	:	43068-1249
Country	:	US
Telephone Number	:	614-746-0596
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2018
Last Update Date	:	04/10/2026

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