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Organization
STARKS THERAPY GROUP
Active
Organization
STARKS THERAPY GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUTUMN STARKS LCSW (OWNER)
(708) 689-9568
Entity
Organization
Contact information
Practice address
1122 WESTGATE ST, 201A, OAK PARK, IL 60301
(708) 689-9568
Mailing address
1122 WESTGATE ST, 201A, OAK PARK, IL 60301
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
180.009523
IL
1041C0700X
Clinical Social Worker
Primary
149.014692
IL
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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