| Nicole Marie Stark, MSW, LCSW | |
|
66 West St, Pittsfield, MA 01201-5861 | |
| (413) 343-4264 | |
| Not Available |
| Full Name | Nicole Marie Stark |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 66 West St, Pittsfield, Massachusetts |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528320181 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LICSW128164 (Massachusetts) | Secondary |
| 1041C0700X | Social Worker - Clinical | 34007088A (Indiana) | Primary |
| Entity Name | Be Authentic Indy Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1841901022 PECOS PAC ID: 7618341496 Enrollment ID: O20230317000399 |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Marie Stark, MSW, LCSW 8606 Allisonville Rd Ste 120, Indianapolis, IN 46250-3585 Ph: (317) 951-9358 | Nicole Marie Stark, MSW, LCSW 66 West St, Pittsfield, MA 01201-5861 Ph: (413) 343-4264 |
Douglas Beaven Spoehr, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 725 North St, Pittsfield, MA 01201 Phone: 413-447-2655 Fax: 413-447-2656 | |
Ashley Jane Wren, Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 66 West St, Pittsfield, MA 01201 Phone: 413-629-1198 | |
Karen Anne Mcnulty, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 725 North Street, Dept Of Psychiatry, Pittsfield, MA 01201 Phone: 413-447-2655 Fax: 413-447-2656 | |
Holly Merchant, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 877 South St Ste 1w, Pittsfield, MA 01201 Phone: 413-443-2994 | |
Karen Browne, LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 139 North St, Pittsfield, MA 01201 Phone: 413-442-4003 | |
Susan Kelly, LICSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 42 Wendell Avenue, Pittsfield, MA 01201 Phone: 413-281-8984 Fax: 413-496-9116 | |
Ms. Laura E Page, MSW LICSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 54 Wendell Ave, Ste 1, Pittsfield, MA 01201 Phone: 413-442-0877 Fax: 413-499-3974 |