Individual provider Active NPI

Caitlin Stark, M.S. LMFT

  • Marriage & Family Therapist
  • Madison, WI
National Provider Identifier
1518580638
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2073-124 Issued in WI
Practice address
406 N Pinckney St
Madison, WI 53703-1410
Phone
(608) 255-8838
NPI assigned
May 22, 2020
Last updated
Feb 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2073-124 WI Primary

Addresses

Primary practice location

406 N Pinckney St
Madison, WI 53703-1410

Mailing address

518 Algoma St
Madison, WI 53704-4813

Other practice location 1

518 Algoma St
Madison, WI 53704-4813
Phone (608) 616-0564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20240419001964 WI Order and Referring Only - Marriage and Family Therapist 0648619866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2073-124WIMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Harmonia Madison Center for Psychotherapy CurrentSince Feb 11, 2024 Accepting new patients

Locations

406 N Pinckney St
Madison, WI 53703
Phone (608) 255-8838

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1518580638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 ALGOMA ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 N PINCKNEY ST",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537031410",
            "telephone_number": "608-255-8838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "518 Algoma St",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "WI",
            "postal_code": "537044813",
            "country_code": "US",
            "telephone_number": "608-616-0564",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STARK",
        "first_name": "CAITLIN",
        "credential": "M.S. LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "2073-124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

Verify at the official NPI Registry.