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SCOTT DAVID STARK LPC
NPI 1215405360
Counselor - Mental Health in Jackson, MI

Active since November 07, 2018PECOS EnrolledAccepts Medicare Assignment
300 W WASHINGTON AVE STE 210B, JACKSON, MI 49201(517) 344-0913 Get Directions Write a Review

NPPES record last updated: November 11, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 11, 2024, Nov 7, 2018 (2 updates tracked since 2018).

About Scott David Stark Lpc NPPES

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

SCOTT DAVID STARK LPC (NPI 1215405360) is an individual mental health provider in Jackson, Michigan and active in the NPI registry since November 2018. He is enrolled in Medicare PECOS, maintains a secondary practice location in Jackson, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1215405360
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameSCOTT DAVID STARKCredential: LPC
Location Address300 W WASHINGTON AVE STE 210BJackson, MI 49201-2160
Mailing Address1508 W Michigan Ave Apt 1Jackson, MI 49202-4025 · (517) 802-0501
Phone(517) 344-0913
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateNovember 7, 2018
Last NPPES UpdateNovember 11, 20242 updates tracked since enumeration
NPPES CertifiedNovember 11, 2024
✔ NPI 1215405360 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
300 W WASHINGTON AVE STE 210B, Jackson, MI 49201
Open in Google Maps ↗

Secondary Practice Location 1

Location 11508 W Michigan Ave Apt 1Jackson, MI 49202-4025 · Phone (517) 802-0501

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Scott David Stark Lpc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2668823469
PECOS Enrollment IDI20240105001883
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Scott Stark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Irwin Counseling Service PLLC
Same address
Mental Health
300 W WASHINGTON AVE STE 210B
Jackson, MI 49201
  • Reassigned Medicare billing, Michigan enrollment
  • 11 clinicians in this Medicare group
NPI 1164946422 (517) 344-0913

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 15

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

SAMUEL BOMMARITO LLPC
Counselor (Mental Health)
300 W WASHINGTON AVE STE 210B
JACKSON, MI 49201
Jackson County (517) 344-0913
GERALDINE SAN JUAN-DUNFORD MA LPC
Counselor (Mental Health)
300 W WASHINGTON AVE STE 210B
JACKSON, MI 49201
Jackson County (517) 344-0913
LESLEY BICY LPC INTERN
Counselor (Mental Health)
300 W WASHINGTON AVE STE 210B
JACKSON, MI 49201
Jackson County (517) 344-0913
MICHAEL HALLECK LPC
Counselor (Mental Health)
300 W WASHINGTON AVE STE 210B
JACKSON, MI 49201
Jackson County (517) 344-0913
IRWIN COUNSELING SERVICE PLLC
Counselor (Mental Health)
300 W WASHINGTON AVE STE 210B
JACKSON, MI 49201
Jackson County (517) 344-0913
REBEKKA BOMMARITO LPC
Counselor (Mental Health)
300 W WASHINGTON AVE STE 210B
JACKSON, MI 49201
Jackson County (517) 344-0913
LINSAY WYKOFF LPC
Counselor (Mental Health)
300 W WASHINGTON AVE STE 210B
JACKSON, MI 49201
Jackson County (517) 344-0913
CLINT WILLIAM IRWIN MA LPC
Counselor (Mental Health)
300 W WASHINGTON AVE STE 210B
JACKSON, MI 49201
Jackson County (517) 344-0913

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Scott Stark's NPI number?

The NPI number for Scott Stark is 1215405360. It was assigned to this individual provider in the NPPES registry on November 7, 2018.

Where is Scott Stark located?

Scott Stark practices at 300 W Washington Ave Ste 210B, Jackson, MI 49201. The listed phone number is (517) 344-0913.

What is Scott Stark's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Scott Stark enrolled in Medicare?

Yes. Scott Stark is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Scott Stark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Scott Stark reassigns Medicare benefits to Irwin Counseling Service PLLC (Jackson, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Scott Stark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Scott Stark accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 3 other insurers list Scott Stark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Scott Stark was last updated on November 11, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.