NPIMap

Organization Active NPI

Tyler M. Stark, Lcmhc, Corp.

  • Community/Behavioral Health Agency
  • Sandy, UT
National Provider Identifier
1083162226
Registry record updated Sep 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
8598755-6004 Issued in UT
Legal business name
TYLER M. STARK, LCMHC, CORP.
Practice address
11075 S State St Ste 16
Sandy, UT 84070-5196
Phone
(801) 948-0939
NPI assigned
Sep 16, 2016
Last updated
Sep 16, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2016

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

Authorized official

Name
Tyler M Stark, LCMHCNPI 1598115669
Title
Owner
Phone
(801) 948-0939

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 8598755-6004 UT Primary

Addresses

Primary practice location

11075 S State St Ste 16
Sandy, UT 84070-5196

Mailing address

11075 S State St Ste 16
Sandy, UT 84070-5196
Phone (801) 948-0939

National Provider Directory

National Provider Directory

Locations

11075 S State St
Ste 16
Sandy, UT 84070
Phone (801) 350-1671

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1083162226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11075 S STATE ST STE 16",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705196",
            "telephone_number": "801-948-0939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11075 S STATE ST STE 16",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705196",
            "telephone_number": "801-948-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TYLER M. STARK, LCMHC, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-948-0939",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "UT",
            "license": "8598755-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; 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.