Individual
JASON STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMHC, CRC
Contact information
Practice address
4910 URBANDALE AVE STE 304, DES MOINES, IA 50310-2661
(515) 669-8111
Mailing address
4910 URBANDALE AVE STE 304, DES MOINES, IA 50310-2661
(515) 446-8797
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
089993
IA
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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