Roselle Stark, MN, APRN, BC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0001162248 Issued in VA

Practice address

8609 Sudley Rd
Suite 201
Manassas, VA 20110-8321

Phone

(703) 577-1492

Fax

(703) 464-0452

NPI assigned

Jul 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

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 and National Provider Directory roles.

• T Med Behavioral Inc

  • Clinical Psychologist
  • Fairfax, VA
  • NPI 1497719272
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445904000000",
    "number": "1275549321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8609 SUDLEY RD",
            "address_2": "SUITE 201",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108321",
            "telephone_number": "703-577-1492",
            "fax_number": "703-464-0452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8609 SUDLEY RD",
            "address_2": "SUITE 201",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108321",
            "telephone_number": "703-577-1492",
            "fax_number": "703-464-0452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "ROSELLE",
        "name_prefix": "Ms.",
        "credential": "MN, APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0001162248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010345308",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alisha Noel Stanley
• Brooke Stanley, LPC
• Loucretia Stanton, OTR/L
• Michelle Lynne Starcher, RPH
• Martin Steven Stark, DPM
• Carrie Jane Starkie, MD
• Starlight Smiles Pediatric Dentistry, P.C.
• Starlight Transportation Services LLC
• Jocelyn Steigleman
• Robert G Stenberg, MD

• Mental Health Counselor in Manassas, VA
• Providers in Manassas, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; 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.