Individual provider · Type 1 NPI
Adam Stark, MA LCMHC LADC
Mental Health Counselor · Brattleboro, VT
NPI number
1679503148
Active
Practice location
122 Birge St 2nd Fl.
Brattleboro, VT 05301
Fax (802) 254-9719
Mailing address
39-8 Brookside Dr
Brattleboro, VT 05301
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 068-0000681 (VT) |
Mental Health Counselor: Definition to come...
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About NPI 1679503148
Adam Stark, MA LCMHC LADC's National Provider Identifier is 1679503148, issued on Jul 3, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Brattleboro, VT. The record was last updated on Dec 13, 2010.