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Individual

DIANE JEAN STARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSSW LCSW

Contact information

Practice address
5034 THOROUGHBRED LN STE D, BRENTWOOD, TN 37027-4231
(615) 507-2082
(615) 507-2085
Mailing address
5034 THOROUGHBRED LN STE D, BRENTWOOD, TN 37027-4231
(615) 507-2082
(615) 507-2085

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
746
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0122302
BLUE CROSS BLUE SHIELD
TN
01
1105848
CIGNA BEHAVIORAL HEALTH
TN
Enumeration date
03/01/2007
Last updated
10/13/2007
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