Stephanie Rose Koeller, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

37F100215200 Issued in NJ

Practice address

440 Franklin St Ste 200
Bloomfield, NJ 07003-4379

Phone

(973) 746-0800

NPI assigned

Jan 12, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Marriage and Family Therapist

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Service League IncGroup PAC ID 4981659034, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Family Service League,Inc.

  • Community/Behavioral Health Agency
  • Bloomfield, NJ
  • NPI 1881855542
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1437748639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 WINSOR ST",
            "city": "BOUND BROOK",
            "state": "NJ",
            "postal_code": "088051752",
            "telephone_number": "908-239-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 FRANKLIN ST STE 200",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070034379",
            "telephone_number": "973-746-0800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 Park St Ste 104",
            "address_purpose": "LOCATION",
            "city": "Montclair",
            "state": "NJ",
            "postal_code": "070422960",
            "country_code": "US",
            "telephone_number": "862-234-5029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOELLER",
        "first_name": "STEPHANIE",
        "middle_name": "ROSE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-12",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NJ",
            "license": "37F100215200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kindersmile Community Oral Health Center
• Latoya S King Robinson, LPC
• Diane Niederhoffer Klein, PH.D.
• Dhyana Kluth, REVEREND
• Frederick James Kluth
• Catherine Colette Koenig, MS, LAT, ATC
• Kaitlyn Elizabeth Kolzow, OD
• Gregory M. Koufacos, M.A., LCADC
• Evgueni Kovaltchouk, PHARMD
• Wioleta Krzton

• Marriage & Family Therapist in Bloomfield, NJ
• Providers in Bloomfield, NJ by specialty
• Marriage & Family Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.