Myra Ann Stark, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

185 44TH St SW Ste B
Grandville, MI 49418-3363

Phone

(616) 244-2246

Fax

(616) 244-2247

NPI assigned

Feb 4, 2016

Last updated

Oct 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Myra Ann Sandford Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

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  NPD (past)

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1730547811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 44TH ST SW STE B",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494183363",
            "telephone_number": "616-244-2246",
            "fax_number": "616-244-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 44TH ST SW STE B",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494183363",
            "telephone_number": "616-244-2246",
            "fax_number": "616-244-2247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "MYRA",
        "middle_name": "ANN",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-04",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801104031",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6801104031",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRA",
            "last_name": "SANDFORD",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Audrey Mikaela St Onge
• Jenna Stack, LMSW
• Isabelle Stankey, PTA
• Tomasz Rafal Stankiewicz, D.O.
• Janet Stark, LLMSW
• Trinity Maree Starling
• David A Start, MD
• Mia A Stecker
• Hannah Rebecca Stegink, LMSW
• Meghan Stepanek, DPT

• Clinical Social Worker in Grandville, MI
• Providers in Grandville, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.