Stark, David J

Stark, David J is an individual health care provider with primary practice located at 940 N Waco Ave , Wichita KS 67203-3947. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Stark, David J can be contacted via phone (316) 660-7550.

Contact Information

Primary practice address
940 N Waco Ave Wichita KS 67203-3947
Phone: (316) 660-7550
Fax: (316) 383-8241
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 5836 Kansas
Behavioral Health & Social Service Providers / Clinical 1041C0700X 053 Kansas

Profile Details

NPI number 1285686998
LBN Legal business name Stark, David J
Credentials LSCSW
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated May 24th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285686998 NPPES
Kansas Other 830153 BLUE CROSS BLUE SHIELD

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