Cortny M Stark, MA, LPCC, LADAC, CRC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

CCMH0198781 Issued in NM

Practice address

1316 Jackie Rd SE Ste 900
Rio Rancho, NM 87124

Phone

(505) 289-1042

NPI assigned

Sep 18, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Credentials

Master of Arts

State licenses

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.

• Trauma Treatment Center LLC

  • Community/Behavioral Health Agency
  • Rio Rancho, NM
  • NPI 1427567486
  Medicare reassignment NPD
• Albuquerque Treatment Services LLC

  • Methadone Clinic
  • Albuquerque, NM
  • NPI 1801032958
  NPD (past)

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

{
    "created_epoch": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1104176148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 INCA RD NE",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "871447558",
            "telephone_number": "505-452-7635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 JACKIE RD SE STE 900",
            "city": "RIO RANCHO",
            "state": "NM",
            "postal_code": "87124",
            "telephone_number": "505-289-1042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Madeira Dr SE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871082963",
            "country_code": "US",
            "telephone_number": "505-262-1538",
            "fax_number": "505-243-5342",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "CORTNY",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "MA, LPCC, LADAC, CRC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CAD0171001",
            "primary": false
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Rehabilitation",
            "state": "NM",
            "license": "00165351",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CCMH0198781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice L Spratte, LPCC
• Deborah Q Spurlock, CNM
• Nicole Johanna Standiford, PHARMD
• Nicole Staniszewski, RN
• Darsha Stanley
• Steel Oral and Maxillofacial Surgery Inc
• Drew Steel, DMD
• Jessica Stephens
• Steven Fife DDS, PC
• Georgia D Stevens, LPCC

• Professional Counselor in Rio Rancho, NM
• Providers in Rio Rancho, NM by specialty
• Professional Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.