Connor Stark, MS, MAS, LAMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LAMFT-10784 Issued in AZ

Practice address

3048 E Baseline Rd Ste 117
Mesa, AZ 85204-7288

Phone

(480) 634-3807

NPI assigned

Feb 16, 2022

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

Credentials

Master of Science

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.

• Bailey Therapy and Consulting, LLC

  • Marriage & Family Therapist
  • Mesa, AZ
  • NPI 1770137069
  NPD

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1386399483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 E BASELINE RD STE 117",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 E BASELINE RD STE 117",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047288",
            "telephone_number": "480-634-3807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "CONNOR",
        "credential": "MS, MAS, LAMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "LAMFT-10784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Ellen Stanton, MS CCC SLP
• Patricia Anne Stapler, MD
• Dana Michelle Stapleton, RDN
• Stapley Dental Group, Professional Corporation
• Kent Wayne Stapley, D.M.D.
• Nancy Stark, OTR/L
• Shannon Lynn Stark, NP
• Tasha Annette Stark, PA-C
• Sara Starks
• Starlight Behavior, LLC

• Marriage & Family Therapist in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Marriage & Family Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.