| Justin Paul Lark, LPC | |
|
6300 N Lucerne Ave, Kansas City, MO 64151-3199 | |
| (505) 231-1997 | |
| Not Available |
| Full Name | Justin Paul Lark |
|---|---|
| Gender | Male |
| Speciality | Counselor - Professional |
| Location | 6300 N Lucerne Ave, Kansas City, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962087445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0018890 (Colorado) | Secondary |
| 101YP2500X | Counselor - Professional | 2020041662 (Missouri) | Primary |
| Entity Name | Sondermind Provider Network Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210812000440 |
| Mailing Address | Practice Location Address |
|---|---|
| Justin Paul Lark, LPC 108 El Camino St, Raton, NM 87740-3608 Ph: (505) 231-1997 | Justin Paul Lark, LPC 6300 N Lucerne Ave, Kansas City, MO 64151-3199 Ph: (505) 231-1997 |
Mrs. Kerry Sue Christifano, M.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 9237 Ward Pkwy Ste 105, Kansas City, MO 64114 Phone: 816-523-2200 | |
Jodie Lynn Rosendal, PLPC, NCC Counselor Medicare: Medicare Enrolled Practice Location: 5545 N Oak Trfy, Kansas City, MO 64118 Phone: 816-500-1355 | |
Dhruti Umang Shah, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3211 Woodland Ave, Kansas City, MO 64109 Phone: 816-966-0900 | |
Cowartiz Merkerson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 8150 Wornall Rd, Kansas City, MO 64114 Phone: 816-508-3500 Fax: 816-508-3535 | |
Dr. Linda Sterling, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 620 E 18th St Ste 203, Kansas City, MO 64108 Phone: 816-455-9433 | |
Mrs. Candis M Boily, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3100 Ne 83rd St Ste 218, Kansas City, MO 64119 Phone: 816-468-0400 | |
Vanidee Stollenwerk, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 7509 Nw Tiffany Springs Pkwy Ste 320, Kansas City, MO 64153 Phone: 816-500-1355 Fax: 816-569-6797 |