CLINT STARKS (NPI# 1437415486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437415486 |
| Entity Type | Individual |
| Full Name | CLINT STARKS |
| Credential | SACIT, LPCIT |
| Practice Address |
480 Underwood Ave Montello WI 53949-9248 |
| Practice Telephone | 6082973181 |
| Practice Fax Number | 6082972148 |
| Mailing Telephone | 6082973181 |
| Mailing Fax Number | 6082972148 |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2016-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
16564130 | WI | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
1577-226 | WI | Behavioral Health & Social Service Providers |
| Street Address |
480 UNDERWOOD AVE |
| City | MONTELLO |
| State | WI |
| Zip Code | 53949-9248 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306841317 | County of Marquette | Ambulance | 480 Underwood Ave, Montello, WI 53949-0181 | 2005-06-16 |
| 1417317751 | Lisa Dedrick | Counselor | 480 Underwood Ave, Montello, WI 53949-9248 | 2016-02-29 |
| 1285094607 | Jeremy Neil Lee | Counselor | 480 Underwood Ave, Montello, WI 53949-9248 | 2016-02-26 |
| 1821479239 | Marquette County Department of Human Services-clinical Services | Case Management | 480 Underwood Ave, Montello, WI 53949-9248 | 2015-06-11 |
| 1003245168 | Tiffany Schmit | Counselor | 480 Underwood Ave, Montello, WI 53949-9248 | 2013-11-08 |
| 1194911644 | James A Webb | Counselor | 480 Underwood Ave, Montello, WI 53949-9248 | 2007-09-19 |
| 1538369350 | Stacy L. Webb | Counselor | 480 Underwood Ave, Montello, WI 53949-9248 | 2007-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013182757 | Marquette County Dhs | Nursing Care | 428 Underwood Ave, Montello, WI 53949 | 2008-04-24 |
| 1588782676 | Jody Ann Triggs | Occupational Therapist | 251 Forest Lane, Montello Care Center, Montello, WI 53949 | 2007-03-27 |
| 1396966560 | Shannon Stacey Harmon | Physical Therapy Assistant | 251 Forest Lane, Montello, WI 53949 | 2007-05-02 |
| 1093734162 | County of Marquette | Public Health or Welfare | 480 Underwood Avenue, Montello, WI 53949-0181 | 2006-07-19 |
| 1326180738 | Irene E Quandt | Chiropractor | 65 W Park Street, Montello, WI 53949-0277 | 2007-02-13 |
| 1093889396 | Bentley Pharmacies Inc | Pharmacy | 25 W Montello St, Montello, WI 53949-0366 | 2006-11-20 |
| 1669706321 | Susan Maxeen Hunter | Marriage & Family Therapist | W4276 Gale Ave, Montello, WI 53949-7718 | 2009-09-29 |
| 1396222345 | Cynthia Joan Jurishica | Social Worker | W5750 Fish Ct, Montello, WI 53949-7862 | 2018-07-23 |
| 1508919390 | Julie Jean Hecker | Licensed Practical Nurse | W814 Arrowhead Road, Montello, WI 53949-7943 | 2007-01-18 |
| 1952590275 | Traci Margene Stalker | Occupational Therapy Assistant | W6112 Fawn Ct, Montello, WI 53949-8049 | 2007-10-23 |
| Find all providers in zip 53949 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417317751 | Lisa Dedrick | Counselor | 480 Underwood Ave, Montello, WI 53949-9248 | 2016-02-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811193 | Leah Marie Benz | Counselor | W3149 Koschnick Rd, Watertown, WI 53094-9415 | 2020-11-05 |
| 1891395174 | Michael Robert Skaggs | Counselor | 8618 Us Highway 51 N, Minocqua, WI 54548-9347 | 2020-10-27 |
| 1760099329 | Spencer Rea Hansen Thomas | Counselor | 3340 Lineville Rd, Green Bay, WI 54313-7237 | 2020-09-28 |
| 1265048029 | Kristen R Coffey | Counselor | 405 E Forest St, Oconomowoc, WI 53066-3707 | 2020-09-17 |
| 1902411663 | Kristen Camille Kapler | Counselor | 3899 Division Rd, Jackson, WI 53037-9707 | 2020-09-10 |
| 1952914780 | Michelle Lee Barth | Counselor | 208 Longview Ave, Green Bay, WI 54301-1034 | 2020-08-31 |
| 1316550197 | All R Welcome LLC | Counselor | 4465 N. Oakland Ave, Shorewood, WI 53211-0041 | 2020-08-31 |
| 1962016766 | Ciara Krueger | Counselor | 2987 Yarmouth Greenway Dr Ste 200, Fitchburg, WI 53711-5852 | 2020-08-31 |
| 1164032983 | Terra Swanson | Counselor | 310a N Brown St, Rhinelander, WI 54501-3103 | 2020-08-06 |
| 1124638069 | Brittney Schultz | Counselor | 405 E Forest St Ste 119, Oconomowoc, WI 53066-3707 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
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| 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.