Stephanie Stark, CG 60743522

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

6201 Pacific Ave Ste C3
Tacoma, WA 98408-7423

Phone

(253) 363-8853

NPI assigned

Sep 25, 2020

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

Other names 1

• Stephanie King Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Life Transitions L.L.C.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tacoma, WA
  • NPI 1609374040
  NPD

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1063029809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 PACIFIC AVE STE C3",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984087423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 PACIFIC AVE STE C3",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984087423",
            "telephone_number": "253-363-8853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "STEPHANIE",
        "name_prefix": "Mrs.",
        "credential": "CG 60743522",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-25",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Tacoma",
            "affiliation": "Y",
            "affiliationName": "Life Transitions Counseling LLC",
            "address_1": "6201 Pacific Ave Ste C3",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984087423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "KING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fhenix Aairon Staples
• Peter B. Staples
• Shannon D Staples, MD
• Star PT, Limited Partnership
• Autumn Star, LSWAIC
• Domonique G Starkey
• Kiefer McQuade Starks, DO
• Samuel C Starks
• Yareiah M. Starks, LICSW
• Jeri Starling, PA

• Mental Health Counselor in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.