Individual
LINDA STARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 TOWNEPARK CIR STE 201, LOUISVILLE, KY 40243-2322
(502) 963-5137
(502) 305-2090
Mailing address
2510 STEEPLECHASE DR, LOUISVILLE, KY 40299-2644
(502) 963-5137
(502) 305-2090
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3988
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100332040
—
KY
Enumeration date
09/07/2011
Last updated
04/03/2018
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