Individual
ALICE ELIZABETH STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW,MHP,CMHS, PHD
Contact information
Practice address
1121 LABURNUM AVE, CHICO, CA 95926-3465
(530) 321-2595
Mailing address
PO BOX 1805, CHICO, CA 95927-1805
(530) 447-2444
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
60626355
WA
1041C0700X
Clinical Social Worker
LCSW105689
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2171336
—
WA
Enumeration date
09/23/2010
Last updated
09/21/2022
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