Glenda R Stark, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5101 Issued in TN

Practice address

2150 Whitney Ave
Memphis, TN 38127-6662

Phone

(901) 353-5440

Fax

(901) 353-5464

NPI assigned

Feb 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Glenda K Rennie Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1497995930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2150 WHITNEY AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381276662",
            "telephone_number": "901-353-5440",
            "fax_number": "901-353-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 WHITNEY AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381276662",
            "telephone_number": "901-353-5440",
            "fax_number": "901-353-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "GLENDA",
        "middle_name": "R",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "6599",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "5101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GLENDA",
            "last_name": "RENNIE",
            "middle_name": "K",
            "credential": "BA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brenda Stanton-Deener, DNP, FNP-BC
• Crystal Ann Stanton, MD
• Jennifer Stapel
• Ronald Carlton Staples, D.D.S.
• Theresa B Stapleton, BS
• Madeline Gail Wurst Stark
• Nathene Lynne Stark, RD, LDN
• Starlight ABA TN LLC
• Sherika Ilean Starnes-Patterson, RBT M.ED
• Deborah Starr

• Clinical Social Worker in Memphis, TN
• Providers in Memphis, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; 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.