NPIMap

Individual provider Active NPI

Lakisha Starks

  • Mental Health Counselor
  • Waldorf, MD
National Provider Identifier
1184206716
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LG50080641 Issued in DC
Practice address
12402 Turtle Dove PL
Waldorf, MD 20602-1400
Phone
(631) 525-8338
NPI assigned
Apr 23, 2021
Last updated
Apr 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LG50080641 DC Primary

Addresses

Primary practice location

12402 Turtle Dove PL
Waldorf, MD 20602-1400

Mailing address

12402 Turtle Dove PL
Waldorf, MD 20602-1400
Phone (631) 525-8338

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LG50080641DCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Inc Past Accepting new patients
Pathways, Inc. Past Accepting new patients
Pathways Inc Mental Health Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1619136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1184206716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12402 TURTLE DOVE PL",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021400",
            "telephone_number": "631-525-8338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12402 TURTLE DOVE PL",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206021400",
            "telephone_number": "631-525-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARKS",
        "first_name": "LAKISHA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-23",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "LG50080641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2021; 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.