Elise A Stark, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

3517 Issued in CT

Practice address

1429 Park Street
Reset Floor One
Hartford, CT 06106-0700

Phone

(860) 685-1254

Fax

(866) 285-7768

NPI assigned

Sep 14, 2018

Last updated

Sep 14, 2018By the provider in NPPES

Sex

Female

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

Enrolled in CT

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

Specialty

Mental Health Counselor

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Step Up Care PC LLCGroup PAC ID 5496088346, 176 clinicians

Mansfield Mental Health and Addiction MedicineGroup PAC ID 6305259243, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mansfield Mental Health and Addiction Medicine

  • Psychiatry Physician
  • Mansfield Center, CT
  • NPI 1366958480

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Step Up Care PC LLC

  • Counselor
  • Danielson, CT
  • NPI 1154884740

  Professional

  Medicare reassignment Care Compare group NPD
• Atlas Outlook

  • Professional Counselor
  • Hartford, CT
  • NPI 1396289344
  NPD (past)

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1477036424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 CAMPBELL AVE",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060665404",
            "telephone_number": "860-685-1254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1429 PARK STREET",
            "address_2": "RESET FLOOR ONE",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061060700",
            "telephone_number": "860-685-1254",
            "fax_number": "866-285-7768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "ELISE",
        "middle_name": "A",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "3517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Lynn Stanford, MD
• Alexander Michael Stangle, DO
• Kate Stanley, LCSW
• Samantha Stannard, RN
• Stephanie Nicole Stapleton, MD
• Phillip Stark, MD
• Megan Starkowski, RN
• Starlighthomecarellc
• Starling Physicians PC
• Carolina V Starr-Manning, RN

• Professional Counselor in Hartford, CT
• Providers in Hartford, CT by specialty
• Professional Counselor in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.