Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JAXSON LAYNE STARK, MS
Active Sole ProprietorJAXSON LAYNE STARK, MS is a Mental Health Counselor healthcare provider located in AMMON, Idaho. NPI 1144559527 is currently active in the NPPES registry. Verify at CMS.
Mental Health Counselor · AMMON, ID
Registration Details
- NPI Number
- 1144559527
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 15, 2009 (16.479394570055 yrs)
- Last Updated
- Dec 6, 2023
- License
-
LCPC 5501 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2705 E 17TH STAMMON, ID, 834066601Browse ID providers · Browse ZIP 83406
- Phone
- 2083600067
- Primary Specialty
-
Mental Health Counselor
101YM0800X
Other Mental Health Counselor Providers in AMMON, ID
| Name | Credential | NPI |
|---|---|---|
| ANGIE JO RADFORD | LMSW | 1831292754 |
| MRS. DEBBIE SMITH | LCSW | 1205017365 |
| MR. ZAKERY R WARREN | LCPC4472 | 1053597344 |
| SHAWN LAPRAY | LCPC | 1609197383 |
| KRYSTALROSE WORTHINGTON | LCPC | 1750687992 |
| ELIZABETH WHITEHEAD | LCPC | 1033469572 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.