MEDICARE: STARK PSYCHOLOGY SERVICES PLLC

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1780479626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STARK PSYCHOLOGY SERVICES PLLC

Provider Business Mailing Address
First Line	:	5122 FLINT ROCK LN
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-8714
Country	:	US
Telephone Number	:	254-262-2262
Fax Number	:

Provider Business Practice Location Address
First Line	:	5122 FLINT ROCK LN
Second Line	:
City	:	TEMPLE
State	:	TX
Zip	:	76502-8714
Country	:	US
Telephone Number	:	254-262-2262
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CLINICAL PSYCHOLOGIST
Name	:	DR. TARA STARK
Credential	:	PSY.D.
Telephone Number	:	254-262-6626

Provider Enumeration Date	:	04/11/2025
Last Update Date	:	01/27/2026

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