Tyler Stark, LCMHC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

8598755-6004 Issued in UT

Practice address

11075 S State St Ste 16
Sandy, UT 84070-5196

Phone

(801) 948-0939

NPI assigned

Jun 20, 2016

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

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.

• Momentum Counseling Services, Corp

  • Mental Health Counselor
  • Sandy, UT
  • NPI 1245729417
  NPD (past) Authorized official

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466380800000",
    "number": "1598115669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11075 S STATE ST STE 16",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705196",
            "telephone_number": "801-948-0939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11075 S STATE ST STE 16",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705196",
            "telephone_number": "801-948-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "TYLER",
        "credential": "LCMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "UT",
            "license": "8598755-6004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Kay Springer, PH.D.
• Alison Janae Springer
• Squire Boys, Inc.
• Standard Optical Co
• Stanley J Phillips DPM PC
• Jezli Steadman
• David Jason Steed, LCSW
• Gregory Kent Steed, LCSW
• Lori Ann Steedman
• June C. Steinvorth, MD

• Professional Counselor in Sandy, UT
• Providers in Sandy, UT by specialty
• Professional Counselor in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; 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.