Charlisa Martrell Stark, PLPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2006033184 Issued in MO

Practice address

108 W Jasper St
Versailles, MO 65084-1020

Phone

(573) 378-6833

NPI assigned

Feb 23, 2007

Last updated

Jul 9, 2007By 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 1

Addresses

Other names 1

• Lisa Martrell Stark Other name

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Adelman & Associates, Inc

  • Clinical Psychologist
  • Versailles, MO
  • NPI 1689773335
  NPD (past)

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1902931447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 PUCKETT RD",
            "city": "ELDON",
            "state": "MO",
            "postal_code": "650264634",
            "telephone_number": "573-280-5065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 W JASPER ST",
            "city": "VERSAILLES",
            "state": "MO",
            "postal_code": "650841020",
            "telephone_number": "573-378-6833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "CHARLISA",
        "middle_name": "MARTRELL",
        "credential": "PLPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2006033184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "STARK",
            "middle_name": "MARTRELL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amanda Kay Shipp, M.D.
• Darrell James Shirk
• Amy L Smith, RPH
• Erin Michelle Smith
• Kimberly Smith, PTA
• Seanna Paige Stevenson, NP-C
• Ida Mae Suttmoller, MA LCSW CASAC
• Erin Svoboda
• Dawn Teschner
• Ivette C Turner, M.D.

• Professional Counselor in Versailles, MO
• Providers in Versailles, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.