Provider Type Icon

KEVIN DOUGLAS STARK PH.D. NPI 1447404918


NPI Information

NPI: 1447404918
Provider Name: KEVIN DOUGLAS STARK, PH.D.
Classification: Psychologist - 103TC2200X
Entity Type: Individual

Specialization: Clinical Child & Adolescent

PECOS Registration: Yes

Address:
1600 W 38TH ST STE 212
AUSTIN, TX
ZIP 78731
Phone: (512) 324-3315
Get Directions

Kevin Douglas Stark, PH.D. is a clinical child and adolescent psychologist in Austin, TX. The provider is a psychologist who develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context. Of particular importance to the specialty of clinical child psychology is an understanding of the basic psychological needs of children and adolescents, and how the family and other social contexts influence the socio-emotional adjustment, cognitive development, behavioral adaptation and health status of children and adolescents. Kevin Douglas Stark, PH.D. NPI is 1447404918. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1600 W 38TH ST STE 212
AUSTIN, TX
ZIP 78731-405
Phone: (512) 324-3315
Fax: (512) 324-3314

The NPI 1447404918 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 11/11/2008 and was last updated on 12/2/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TB0200XPsychologistCognitive & Behavioral2-3732TEXASNo
2103TC2200XPsychologistClinical Child & Adolescent2-3732TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1317951YKYMMEDICARE PINTEXAS
2317951YRLZMEDICARE PINTEXAS
3328753401MEDICAIDTEXAS
4328753402MEDICAIDTEXAS
5328753403MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.