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

Jeremy M Stark, LCSW

Individual provider Social Worker · NPI 1154772689

Jeremy M Stark, LCSW is a Social Worker in Fayetteville, Arkansas. Licensed in Arkansas. Registered with an NPI since 2016.

Licensed in
AR
In the registry since
2016
Specialties on file
2
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

60 W Sunbridge Dr
Fayetteville, AR 72703-1822
Phone: (479) 695-1240
Fax: (479) 750-4843
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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 8044-C (AR)
Social Worker Taxonomy 104100000X · Licence 8044-M (AR)

Record details

NPI number1154772689
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedJune 27, 2016
Last updated in NPPESDecember 14, 2018

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