NPI Registry.org

Myra Ann Stark

NPI Registration Record

Provider / OrganizationNPIDate Certified
MYRA ANN STARK17305478112022-06-19

Myra Ann Stark is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1730547811. Registration indicates Myra Ann Stark is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care) Access to Mental Health/Behavioral Health Providers (Behavioral Health & Social Service Providers, Social Worker) (Behavioral Health & Social Service Providers, Social Worker) (Social Worker, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Social Worker, Behavioral Health & Social Service Providers)

Entity TypeIndividual
Provider Name Myra Ann Stark MSW
Other Provider Name Myra Ann Sandford
Practice Office Address185 44TH ST SW STE B
GRANDVILLE, MI US
Practice Office Telephone6162442246
Practice Office Fax6162442247
Mailing Address185 44TH ST SW STE B
GRANDVILLE, MI 494183363 US
Business Telephone6162442246
Business Fax6162442247
HPT Codes
CodePractice
License No
State
390200000X
Student, Health Care
Student in an Organized Health Care Education/Training Program
Student in an Organized Health Care Education/Training Program

All Other Specialties & Provider Types

Student in an Organized Health Care Education/Training Program
Student, Health Care
104100000X PRIMARYAccess to Mental Health/Behavioral Health Providers
Behavioral Health & Social Service Providers
Social Worker
Behavioral Health & Social Service Providers
Social Worker
Social Worker

Behavioral Health/Substance Abuse/Psychiatry

Social Worker
Behavioral Health & Social Service Providers
6801104031
MI
OPI Codes
6801104031 MEDICAID MI
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