Active NPI
Tiffany Ann Stark, APSW
- Social Worker
- Mequon, WI
National Provider Identifier
1669712691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- Practice address
- 10532 N Port Washington Rd
Mequon, WI 53092-5563 - Phone
- (262) 242-3810
- Fax
- (262) 242-3816
- NPI assigned
- Feb 28, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | Primary |
Addresses
Primary practice location
10532 N Port Washington Rd
Mequon, WI 53092-5563
Mailing address
10532 N Port Washington Rd
Mequon, WI 53092-5563
Phone (262) 242-3810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1362009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362009600000",
"number": "1669712691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10532 N PORT WASHINGTON RD",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925563",
"telephone_number": "262-242-3810",
"fax_number": "262-242-3816"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10532 N PORT WASHINGTON RD",
"city": "MEQUON",
"state": "WI",
"postal_code": "530925563",
"telephone_number": "262-242-3810",
"fax_number": "262-242-3816"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STARK",
"first_name": "TIFFANY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "APSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-28",
"last_updated": "2013-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mequon, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.