Stages Health & Wellness, LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.012605 Issued in IL

Legal business name

STAGES HEALTH & WELLNESS, LLC

Practice address

122 E Main St Ste 124
Lakeland, FL 33801-4655

Phone

(863) 837-4867

Fax

(863) 228-8510

NPI assigned

Jan 5, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Monique L Manderson, FNP-C, PMHNP-BC

Title

Ceo/Founder

Phone

(863) 837-4867

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1515110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1417464918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E MAIN ST STE 124",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014655",
            "telephone_number": "863-837-4867",
            "fax_number": "863-228-8510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 E MAIN ST STE 124",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014655",
            "telephone_number": "863-837-4867",
            "fax_number": "863-228-8510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAGES HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-05",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "MANDERSON",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "863-837-4867",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "FNP-C, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.012605",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.