Individual provider Active NPI

Juliana P Stolker, LPC

  • Mental Health Counselor
  • Eatontown, NJ
National Provider Identifier
1407572936
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
37AC00601000 Issued in NJ
Practice address
615 Hope Rd BLDG 5B2ND
Eatontown, NJ 07724-1277
Phone
(732) 389-0697
Fax
(732) 389-0611
NPI assigned
Oct 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 37AC00601000 NJ Primary

Addresses

Primary practice location

615 Hope Rd BLDG 5B2ND
Eatontown, NJ 07724-1277

Mailing address

615 Hope Rd BLDG 5B2ND
Eatontown, NJ 07724-1277
Phone (732) 389-0697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250616000064 NJ Practitioner - Mental Health Counselor 6800307166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Care Concepts and Consultation, LLCGroup PAC ID 6709303357, 12 clinicians

Practice addresses (Care Compare)

615 Hope Rd
Suite 5B
Eatontown, NJ 07724-1273
Phone (732) 389-0697

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37AC00601000NJMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerment Diversity and Inclusion Mental Health CurrentSince Oct 23, 2022 Accepting new patients
Integrated Care Concepts & Consultation, LLC CurrentSince May 8, 2025 Accepting new patients

Locations

615 Hope Rd
Bldg 5B2ND
Eatontown, NJ 07724
Phone (732) 389-0697

615 Hope Rd
Tinton Falls, NJ 07724
Phone (732) 389-0697

615 Hope Rd
Ste 5B
Tinton Falls, NJ 07724
Phone (732) 389-0697

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1407572936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HOPE RD BLDG 5B2ND",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-389-0697",
            "fax_number": "732-389-0611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 HOPE RD BLDG 5B2ND",
            "city": "EATONTOWN",
            "state": "NJ",
            "postal_code": "077241277",
            "telephone_number": "732-389-0697",
            "fax_number": "732-389-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLKER",
        "first_name": "JULIANA",
        "middle_name": "P",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00601000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatontown, NJ

Sources for this page

Verify at the official NPI Registry.