Kelly Lynn Stolberg, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05445400 Issued in NJ

Practice address

253 Witherspoon St
Eating Disorders Program
Princeton, NJ 08540-3211

Phone

(609) 497-4000

Fax

(609) 497-4412

NPI assigned

Aug 22, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 13, 2016 through Feb 13, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291939200000",
    "number": "1497902209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 WITHERSPOON ST",
            "address_2": "EATING DISORDERS PROGRAM",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403211",
            "telephone_number": "609-497-4000",
            "fax_number": "609-497-4412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 WITHERSPOON ST",
            "address_2": "EATING DISORDERS PROGRAM",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085403211",
            "telephone_number": "609-497-4000",
            "fax_number": "609-497-4412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOLBERG",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2010-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05505400",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05445400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Thomas Stier, M.D.
• Peter K Stimpson, M.S.W., M.TH.
• Darlene Stinchcomb, PTA
• Chad Eric Stockham, M.D.
• Namhee Stokvis, PSYD
• Lona M Stranieri, LCSW
• Strata Wellness Collective
• Richard Strauss
• Sofia K Strauss, LSW
• Alan Lawrence Stricoff, D.O.

• Clinical Social Worker in Princeton, NJ
• Providers in Princeton, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.