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

Wade M Stark

Individual provider Professional Counselor · NPI 1801430988

Wade M Stark is a Mental Health Counselor in Charleston, Illinois. Qualified in 2011, 15 years ago. Practices with Southern Illinois Healthcare Foundation Inc, a 118-clinician group and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
15
Licensed in
IL
In the registry since
2019
Specialties on file
2

Practice location Address checks out

626 W Lincoln Ave
Charleston, IL 61920-2444
Phone: (217) 345-7702
Fax: (217) 345-7705
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 180013660 (IL)
Professional Counselor Taxonomy 101YP2500X

Record details

NPI number1801430988
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedNovember 1, 2019
Last updated in NPPESJune 12, 2025
Certification dateJune 12, 2025
Mailing address626 W Lincoln Ave, Charleston, IL 61920-2444

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Southern Illinois Healthcare Foundation Inc — 118 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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