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

Juliann Fae Stark

Individual provider Professional Counselor · NPI 1740980408

Juliann Fae Stark is a Mental Health Counselor in Woodbury, Minnesota. Qualified in 2023, 3 years ago. Practices with Nystrom and Associates Ltd, a 617-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
3
Licensed in
MN
In the registry since
2023
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Practice location Address checks out

1811 Weir Dr Ste 270
Woodbury, MN 55125-6741
Phone: (651) 714-9646
Fax: (651) 714-9647
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 5171 (MN)

Record details

NPI number1740980408
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMarch 9, 2023
Last updated in NPPESOctober 7, 2025
Certification dateOctober 7, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Nystrom And Associates Ltd — 617 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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