Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jason Stark, LCSW

Individual provider Clinical Social Worker · NPI 1609998574

Jason Stark, LCSW is a Clinical Social Worker in Ithaca, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2007
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

903 Hanshaw Rd
Ithaca, NY 14850-1530
Phone: (607) 592-2377
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 082965 (NY)

Record details

NPI number1609998574
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedApril 4, 2007
Last updated in NPPESJuly 7, 2023
Certification dateJuly 7, 2023
Mailing address903 Hanshaw Rd, Ithaca, NY 14850-1530

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