Organization Active NPI

Starfish Experience NC

  • Mental Health Counselor
  • Westwood, NJ
National Provider Identifier
1417021064
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SC04387700 Issued in NJ
Legal business name
STARFISH EXPERIENCE NC
Practice address
192 3Rd Ave
Westwood, NJ 07675-2154
Phone
(201) 594-9900
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Sheila Kaminski, LCSWNPI 1336253806
Title
President
Phone
(201) 594-9900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 44SC04387700 NJ Primary

Addresses

Primary practice location

192 3Rd Ave
Westwood, NJ 07675-2154

Mailing address

58 Hickory Hill LN
Tappan, NY 10983-1825
Phone (845) 359-1539

National Provider Directory

National Provider Directory

Locations

192 3rd Ave
Westwood, NJ 07675
Phone (201) 594-9900

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417021064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 HICKORY HILL LN",
            "city": "TAPPAN",
            "state": "NY",
            "postal_code": "109831825",
            "telephone_number": "845-359-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 3RD AVE",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076752154",
            "telephone_number": "201-594-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARFISH EXPERIENCE NC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KAMINSKI",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-594-9900",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC04387700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.