Individual provider · Type 1 NPI

Robert Stark, MA, CMHC

Mental Health Counselor · Provo, UT

NPI number 1215197405 Active

Practice location

750 N Freedom Blvd Ste 300
Provo, UT 84601-1690

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400XNone listed
Mental Health Counselor 101YM0800XNone listed
Professional Counselor 101YP2500X900 (CA)
Mental Health Counselor Primary 101YM0800X11425200-6004 (UT)

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About NPI 1215197405

Robert Stark, MA, CMHC's National Provider Identifier is 1215197405, issued on Jun 11, 2008. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Provo, UT. The record was last updated on Jan 27, 2025.