KELLY STARK (NPI# 1114343985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114343985 |
| Entity Type | Individual |
| Full Name | KELLY STARK |
| Practice Address |
3422 S 15th E Idaho Falls ID 83404-8262 |
| Practice Telephone | 2085521222 |
| Mailing Telephone | 2085521222 |
| Enumeration Date | 2014-03-17 |
| Last Update Date | 2014-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LMSW -33495 | ID | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023372893 | Kelly Lynn Stark | Licensed Practical Nurse | 1174 Starr Rd, Apt 11, Cortland, NY 13045-6809 | 2012-06-27 |
| 1336615574 | Kelly Stark | Occupational Therapy Assistant | 2495 Main St, Buffalo, NY 14214-2152 | 2018-10-15 |
| 1104332006 | Kelly Ann Stark | Massage Therapist | 2167 Nw 185th Ave, Hillsboro, OR 97124-7074 | 2017-12-15 |
| Street Address |
3422 S 15TH E |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-8262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285621532 | Michael T Harris Md, PC | Clinic/Center | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2005-10-03 |
| 1760044424 | Phillip Marlowe | Radiologic Technologist | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2019-07-02 |
| 1215314968 | Hsiang-hua Wang | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2015-05-01 |
| 1912335738 | Family Resource Centers of America, Inc | Clinic/Center | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2013-10-15 |
| 1164712899 | Sawtooth Rehab, Pllc | Specialist | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2011-04-14 |
| 1720387681 | Travis Scott Hull | Social Worker | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2011-03-17 |
| 1376877795 | David Aaron Petty | Allergy & Immunology | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2009-10-01 |
| 1235363169 | Maria Teresa Alvarado | Counselor | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2009-05-06 |
| 1982841334 | Karen Elise Bender | Registered Nurse | 3422 S 15th E, The Healing Sanctuary, Idaho Falls, ID 83404-8262 | 2009-01-07 |
| 1861651812 | Michael Rex | Social Worker | 3422 S 15th E, Idaho Falls, ID 83404-8262 | 2008-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609410489 | Angelika H Gutenberger | Counselor | 211 S Woodruff Ave Ste A3, Idaho Falls, ID 83401-4865 | 2019-11-04 |
| 1851859110 | Rebecca Chidester | Counselor | 771 Parkwood St., Idaho Falls, ID 83401 | 2019-03-06 |
| 1124590302 | A Penney for Your Thoughts, LLC | Counselor | 1820 E 17th St Ste 190, Idaho Falls, ID 83404-6518 | 2018-12-27 |
| 1346790128 | Molli Gilchrist | Counselor | 760 K St Apt B, Idaho Falls, ID 83402-2770 | 2016-10-05 |
| 1508256850 | Itzel Montero | Counselor | 3442 S. 15th E., Idaho Falls, ID 83404 | 2015-01-26 |
| 1457610149 | Kimberly W. Johnson | Counselor | 1934 N 26th W, Idaho Falls, ID 83402-5319 | 2012-05-15 |
| 1477823490 | Annette Marie Cowley | Counselor | 1273 E 17th St, Idaho Falls, ID 83404-6126 | 2012-01-06 |
| 1619102183 | Quinn Blake Thibodeau | Counselor | 1891 Grandview Ct, Idaho Falls, ID 83402-2510 | 2009-05-27 |
| 1679711998 | New Journeys Inc | Counselor | 1047 Oxbow Ln, Idaho Falls, ID 83404-8351 | 2009-01-23 |
| 1093964041 | Nathan James Fullmer | Counselor | 4707 1st St, Idaho Falls, ID 83401-5771 | 2008-09-15 |
| Find all providers in IDAHO FALLS | ||||
| City | IDAHO FALLS |
| Zip Code | 83404 |
Please comment or provide details below to improve the information on KELLY STARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.