Charlisa Martrell Stark, PLPC
Individual provider Active NPI Professional Counselor · Versailles, MO
NPI 1902931447 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1902931447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2006033184 (MO)
- Practice address
- 108 W Jasper St
Versailles, MO 65084-1020 - Phone
- (573) 378-6833
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006033184 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Adelman & Associates, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2006033184 | MO | Yes |
Addresses
Primary practice location
108 W Jasper St
Versailles, MO 65084-1020
Mailing address
18 Puckett Rd
Eldon, MO 65026-4634
Phone (573) 280-5065
Other names
- Lisa Martrell Stark
Other providers in Versailles, MO
- Amanda Kay Shipp
- Darrell James Shirk
- Amy L Smith
- Erin Michelle Smith
- Kimberly Smith
- Seanna Paige Stevenson
- Ida Mae Suttmoller
- Erin Svoboda
- Dawn Teschner
- Ivette C Turner
All providers in Versailles, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.