Individual
CLINT STARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SACIT, LPCIT
Contact information
Practice address
480 UNDERWOOD AVE, MONTELLO, WI 53949-9248
(608) 297-3181
(608) 297-2148
Mailing address
480 UNDERWOOD AVE, MONTELLO, WI 53949-9248
(608) 297-3181
(608) 297-2148
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16564130
WI
101YP2500X
Professional Counselor
Primary
1577-226
WI
Other
Enumeration date
04/04/2012
Last updated
03/16/2016
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