Stony Brook Holistic Wellness, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

STONY BROOK HOLISTIC WELLNESS, LLC

Practice address

2500 Nesconset Hwy BLDG 26
Stony Brook, NY 11790-2555

Phone

(631) 364-9038

NPI assigned

Apr 7, 2025

Last updated

Apr 25, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Raymond Louis, PHD

Title

Cfo

Phone

(631) 653-1007

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kathleen Mauro, CPT ACE

  • Personal Care Attendant
  • Stony Brook, NY
  • NPI 1457244345
  NPD
• Stephen Albert Probst, MD

  • Anesthesiology Physician
  • Stony Brook, NY
  • NPI 1982871679
  NPD
• Angela Debrodt, MS, RN, AGNP-C

  • Adult Health Nurse Practitioner
  • Stony Brook, NY
  • NPI 1295271419

  Registered Nurse

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777075200000",
    "number": "1235923269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 26",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-364-9038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NESCONSET HWY BLDG 26",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117902555",
            "telephone_number": "631-364-9038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONY BROOK HOLISTIC WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-07",
        "last_updated": "2026-04-25",
        "certification_date": "2026-04-25",
        "status": "A",
        "authorized_official_last_name": "LOUIS",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "631-653-1007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.