Stark, Diane Jean

Stark, Diane Jean is an sole proprietor health care provider with primary practice located at 5034 Thoroughbred Ln Ste D , Brentwood TN 37027-4231. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Stark, Diane Jean can be contacted via phone (615) 507-2082.

Contact Information

Primary practice address
5034 Thoroughbred Ln Ste D Brentwood TN 37027-4231
Phone: (615) 507-2082
Fax: (615) 507-2085
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 746 Tennessee

Profile Details

NPI number 1780712943
LBN Legal business name Stark, Diane Jean
Credentials MSSW LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 1st, 2007
Last updated Oct 13th, 2007 - about 18 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 1780712943 NPPES
Tennessee Other 0122302 BLUE CROSS BLUE SHIELD
Tennessee Other 1105848 BLUE CROSS BLUE SHIELD

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