Jason Stark, LMHC, CRC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

089993 Issued in IA

Practice address

4910 Urbandale Ave Ste 304
Des Moines, IA 50310-2661

Phone

(515) 669-8111

NPI assigned

Mar 12, 2019

Last updated

Mar 12, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Affinity Therapy and Counseling Services

  • Mental Health Counselor
  • Des Moines, IA
  • NPI 1891147310
  NPD (past)

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1225596935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 URBANDALE AVE STE 304",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503102661",
            "telephone_number": "515-446-8797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 URBANDALE AVE STE 304",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503102661",
            "telephone_number": "515-669-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "JASON",
        "credential": "LMHC, CRC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-12",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "089993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marina V. Stankovich, M.D.
• John Joseph Stanley, MSW LISW
• Star Jammerz Inc
• Anthony Robert Stark, D.O.
• Craig A Stark, M.D.
• Brenden Starkey, DO
• Ellen Starkey, ARNP
• Ryan Eric Starkman
• Christal Gayle Starr, CADC
• Julie A Starry, A.R.N.P.

• Mental Health Counselor in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Mental Health Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2019; 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.