Stark, Roselle

Stark, Roselle is an individual health care provider with primary practice located at 8609 Sudley Rd Suite 201, Manassas VA 20110-8321. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Stark, Roselle can be contacted via phone (703) 577-1492.

Contact Information

Primary practice address
8609 Sudley Rd Suite 201 Manassas VA 20110-8321
Phone: (703) 577-1492
Fax: (703) 464-0452
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0001162248 Virginia

Profile Details

NPI number 1275549321
LBN Legal business name Stark, Roselle
Credentials MN, APRN, BC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 31st, 2006
Last updated Oct 27th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275549321 NPPES
Virginia MEDICAID 010345308

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