Provider Demographics
NPI:1912353228
Name:STARKS COUNSELING AND CONSULTATION SERVICES
Entity Type:Organization
Organization Name:STARKS COUNSELING AND CONSULTATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:KIMBERLY
Authorized Official - Last Name:STARKS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:614-484-0919
Mailing Address - Street 1:175 S 3RD ST
Mailing Address - Street 2:200
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5134
Mailing Address - Country:US
Mailing Address - Phone:614-484-0919
Mailing Address - Fax:
Practice Address - Street 1:175 S 3RD ST
Practice Address - Street 2:200
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5134
Practice Address - Country:US
Practice Address - Phone:614-484-0919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 16001161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1972931483OtherNPPES