Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1114343985 Individual Practitioner Female Practitioner

Kelly Stark

Social Worker • Ammon, ID

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Kelly Stark is a registered Social Worker practitioner in Ammon, ID. With approximately 15 years of clinical practice since completing medical education in 2011, Kelly Stark provides healthcare services at the registered practice location at 2705 E 17TH ST.

Kelly Stark does not directly accept Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

2705 E 17th St

Ammon, ID 834066669

Telephone 2083467500
Fax 2083467501
Associated Practice Facility / Clinic
🏢 Pearl Health Clinic Facility NPI 1447426465

Medicare Profile & Education

Medical School

Other

Graduation Year

2011

Medicare Assignment

Not Specified

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Social Worker in Ammon, ID

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
15 Yrs +6.3 yrs vs City Avg
City Avg: 8.7 Yrs
State Avg: 11.2 Yrs
Regional Practice Density
81 Specialists

Practicing in Ammon, ID (1625 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Stark (15 Years) 15 Yrs
Ammon Specialty Average (8.7 Years) 8.7 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-11-25
Social Worker Primary Specialty

NUCC Taxonomy Code: 104100000X

State License ID LMSW-33495

A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Jayde Barnes , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1023618659

Psychiatric-Mental Health Nurse Practitioner

Jodi Dennett

Counselor - Mental Health

NPI 1033908306
Sarah Clark

Peer Specialist

NPI 1033964796
Itzel Valencia , BS

Social Worker

NPI 1043645740

Bachelor of Science

Siu Ling Chi

Counselor - Professional

NPI 1043829062
Zakery Warren , LCPC4472

Counselor - Mental Health

NPI 1053597344

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location November 25, 2025

Registered at 2705 E 17TH ST, AMMON, ID 834066669 (Tel: 2083467500)

📍
Updated Business Mailing Address November 25, 2025

Registered at 2705 E 17TH ST, AMMON, ID 834066669 (Tel: 2083467500)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 25, 2025

Social Worker (License #LMSW-33495 in ID)

NPI Profile Active March 17, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location March 17, 2014

Registered at 3422 S 15TH E, IDAHO FALLS, ID 834048262 (Tel: 2085521222)

📍
Updated Business Mailing Address March 17, 2014

Registered at 3422 S 15TH E, IDAHO FALLS, ID 834048262 (Tel: 2085521222)

👤
Provider Name / Credentials Updated March 17, 2014

Recorded as KELLY STARK

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 17, 2014

Counselor (License #LMSW -33495 in ID)

🟢
Initial NPI Registration & Enumeration March 17, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Kelly Stark. Be the first to share your experience!

Sign in to leave a review for Kelly Stark

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1114343985
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 17, 2014
Last Update: November 25, 2025
Sole Proprietor: No

Mailing Address

2705 E 17th St

Ammon, ID 834066669

Phone: 2083467500

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.