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STEPHEN STARK
Clinical >> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1881246486
Individual Registrant: STEPHEN STARK
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
38 WHITEHOUSE RD HOLLIS CENTER, ME 04042-3340 US
Tel: 207-619-2102 Fax: --
Tel: 207-619-2102 Fax: --
Contact information for business:
38 WHITEHOUSE RD HOLLIS CENTER, ME 04042-3340 US
Tel: 207-619-2102 Fax: --
Tel: 207-619-2102 Fax: --
Registration Information:
NPI: 1881246486
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 1041C0700X | Behavioral Health & Social Service Providers Social Worker Clinical | ME | MC18084 |
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker | ME | LC20359 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
