Caroline Lynn Soon Stark, MSW, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

26684 Issued in MN

Practice address

2303 Wycliff St Ste W210
Saint Paul, MN 55114-1272

Phone

(612) 424-0434

Fax

(877) 905-7069

NPI assigned

Sep 9, 2020

Sex

Female

Sole proprietor

No

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 MN

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Susan Borden PsychGroup PAC ID 4688011612, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Susan Borden Psych

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Paul, MN
  • NPI 1780313478
  Medicare reassignment Care Compare group NPD
• Youable Emotional Health Services

  • Community/Behavioral Health Agency
  • Richfield, MN
  • NPI 1386728228
  NPD

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1043825946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2303 WYCLIFF ST STE W210",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141272",
            "telephone_number": "612-424-0434",
            "fax_number": "877-905-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 WYCLIFF ST STE W210",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141272",
            "telephone_number": "612-424-0434",
            "fax_number": "877-905-7069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Highway 7 Ste 309",
            "address_purpose": "LOCATION",
            "city": "Hopkins",
            "state": "MN",
            "postal_code": "553054737",
            "country_code": "US",
            "telephone_number": "952-426-6601",
            "fax_number": "952-938-4708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6425 Nicollet Ave",
            "address_purpose": "LOCATION",
            "city": "Richfield",
            "state": "MN",
            "postal_code": "554231675",
            "country_code": "US",
            "telephone_number": "612-861-1675",
            "fax_number": "612-861-3446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5910 Shingle Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Center",
            "state": "MN",
            "postal_code": "554302322",
            "country_code": "US",
            "telephone_number": "763-569-5200",
            "fax_number": "763-569-5201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "CAROLINE",
        "middle_name": "LYNN SOON",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "26684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Stapleton, LM, CPM
• Shaun Philip Stapleton
• Cynthia M Starbuck, DC
• Ricki Starck, LMFT
• Starfish Center Inc
• Linda Jo Starks, NP
• Adam Starr, MD
• William Starr, PT, DPT
• Stars Medical Transportation
• Lee Start, MSW, LICSW, LADC

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.