Jennifer L Starck, QMHP

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

694 Church St NE
Salem, OR 97301-2401

Phone

(503) 581-5535

Fax

(503) 391-5291

NPI assigned

Apr 21, 2010

Last updated

Jul 15, 2016By 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 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• J Starck LCSW Counseling and Consultation Services LLC

  • Social Worker
  • Salem, OR
  • NPI 1679431852
  NPD Authorized official

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1689991226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 CHURCH ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012401",
            "telephone_number": "503-581-5535",
            "fax_number": "503-391-5291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 CHURCH ST NE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973012401",
            "telephone_number": "503-581-5535",
            "fax_number": "503-391-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARCK",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "QMHP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misha Noelle Stanley
• Alexandra Staples, PT, DPT
• Joseph Staples
• Laura Lee Staples, LMT
• John Stapleton, PTA
• Kristian Nicole Stargardt
• Starling Oncology Or, a Professional Corporation (Starling Oncology)
• Westley J Starling, LCSW
• Amanda R Starr Morris, MS
• Stars Interpreters LLC

• Social Worker in Salem, OR
• Providers in Salem, OR by specialty
• Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.