Susan D Stark, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

029640-R Issued in NY

Practice address

500 E 16TH St
Brooklyn, NY 11226-6507

Phone

(917) 751-3623

NPI assigned

Apr 27, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Park Slope Center for Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn, NY
  • NPI 1851382188
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609459200000",
    "number": "1013974666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E 16TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112266507",
            "telephone_number": "718-998-2908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E 16TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112266507",
            "telephone_number": "917-751-3623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2021-01-01",
        "certification_date": "2021-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "029640-R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikki Stark
• Reizel Stark
• Roman Stark, LMSW
• Sarah Stark
• Shevy Stark, MS, ED
• Charles H Starke II, M.D.
• Christine Starke, MS CCC-SLP, TSSLD
• Alisa Marie Starks
• Melissia Starks
• Starlight ABA LLC

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.