Autumn Star, LSWAIC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SC61340456 Issued in WA

Practice address

2602 S 38TH St
Tacoma, WA 98409-7303

Phone

(585) 730-0050

NPI assigned

Aug 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1033837729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 S 38TH ST",
            "address_2": "STE A #270",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097303",
            "telephone_number": "585-730-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 S 38TH ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984097303",
            "telephone_number": "585-730-0050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAR",
        "first_name": "AUTUMN",
        "credential": "LSWAIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "SC61340456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina Stapke, RDN
• Fhenix Aairon Staples
• Peter B. Staples
• Shannon D Staples, MD
• Star PT, Limited Partnership
• Stephanie Stark, CG 60743522
• Domonique G Starkey
• Kiefer McQuade Starks, DO
• Samuel C Starks
• Yareiah M. Starks, LICSW

• Clinical Social Worker in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.