DR. KATE STARK PHD
NPI 1043697774
Psychologist in Southlake, TX

Active since May 01, 2015Opted out of Medicare · through Apr 1, 2028
1723 E SOUTHLAKE BLVD STE 200, SOUTHLAKE, TX 76092(682) 292-7012 Get Directions Write a Review

NPPES record last updated: September 3, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 3, 2022, Jun 7, 2019 (2 updates tracked since 2019).

About Dr. Kate Stark Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KATE STARK PHD (NPI 1043697774) is an individual psychologist in Southlake, Texas, licensed in Texas (37628) and active in the NPI registry since May 2015. She has opted out of Medicare through April 1, 2028.

NPPES Registry Identity

NPI1043697774
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. KATE STARKCredential: PHD
Location Address1723 E SOUTHLAKE BLVD STE 200Southlake, TX 76092-6445
Mailing Address1723 E Southlake BlvdSouthlake, TX 76092-6444 · (682) 292-7012
Sole ProprietorNo
Enumeration DateMay 1, 2015
Last NPPES UpdateSeptember 3, 20222 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2022
NPI 1043697774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Licenses Licensed in TX · 37628 Licensed in CO · PSY.0004166
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

Also ListedPsychologist · SchoolTaxonomy 103TS0200X · License 101523 (CO), 71112 (TX)
1723 E SOUTHLAKE BLVD STE 200, Southlake, TX 76092

Other Names 1

Former Name (1)Kate Elizabeth Harris

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Kate Stark Phd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2026 through April 1, 2028.

Opt-Out Effective DateApril 1, 2026
Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychologist
1723 E SOUTHLAKE BLVD STE 200
SOUTHLAKE, TX 76092
Psychologist
1723 E SOUTHLAKE BLVD STE 200
SOUTHLAKE, TX 76092
Psychologist (Clinical)
1723 E SOUTHLAKE BLVD STE 200
SOUTHLAKE, TX 76092
Social Worker
1723 E SOUTHLAKE BLVD STE 200
SOUTHLAKE, TX 76092

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043697774, enumerated as an "individual" on May 01, 2015.

The provider is located at 1723 E SOUTHLAKE BLVD STE 200 SOUTHLAKE, TX 76092 and the phone number is (682) 292-7012.

Psychologist with taxonomy code 103T00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas, Oscar. Please consult your insurance carrier or call the provider to verify.