Individual provider · Type 1 NPI

Jeremy M. Stark, LCSW

Clinical Social Worker · Fayetteville, AR

NPI number 1154772689 Active

Practice location

60 W Sunbridge Dr
Fayetteville, AR 72703-1822

Call (479) 695-1240 Map

Fax (479) 750-4843

Mailing address

2400 S 48th St
Springdale, AR 72762-6683

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000X8044-M (AR)
Clinical Social Worker Primary 1041C0700X8044-C (AR)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1154772689

Jeremy M. Stark, LCSW's National Provider Identifier is 1154772689, issued on Jun 27, 2016. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fayetteville, AR. The record was last updated on Dec 14, 2018.