| Amy J. Stark, LLC | |
|
9666 Olive Blvd Ste 370 Olivette MO 63132-3025 | |
| (314) 971-5272 | |
| Not Available |
| Full Name | Amy J. Stark, LLC |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 9666 Olive Blvd Ste 370, Olivette, Missouri |
| Authorized Official Name and Position | Amy J. Stark (THERAPIST/MANAGER/SOLE MEMBER) |
| Authorized Official Contact | 3149715272 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amy J. Stark, LLC 729 Chippendale Ct Kirkwood MO 63122-5705 Ph: (314) 971-5272 | Amy J. Stark, LLC 9666 Olive Blvd Ste 370 Olivette MO 63132-3025 Ph: (314) 971-5272 |
| NPI Number | 1346927308 |
|---|---|
| Provider Enumeration Date | 06/30/2023 |
| Last Update Date | 06/30/2023 |
| Certification Date | 06/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346927308 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (NU) | Primary |
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