Stellar Clinic NJ LLC

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

STELLAR CLINIC NJ LLC

Practice address

7216 Bergenline Ave # 1003
North Bergen, NJ 07047-5489

Phone

(973) 320-7004

NPI assigned

Jun 18, 2024

Organization subpart

No

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

Authorized official

Name

George Wang

Title

Chief Administrative Officer

Phone

(415) 343-5839

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Edward M Lysaght, LCSW

  • Clinical Social Worker
  • Phillipsburg, NJ
  • NPI 1508898347
  Medicare reassignment Care Compare group
• Daniela Szatkowski, LCSW

  • Clinical Social Worker
  • Freehold, NJ
  • NPI 1902352834
  Medicare reassignment Care Compare group
• Dacontee J Davis, LCSW

  • Clinical Social Worker
  • Philadelphia, PA
  • NPI 1912503590

  NJ

  Medicare reassignment Care Compare group
• Jonah Mink, MD

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1083052351
  NPD (past)

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1528801446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N BARRANCA AVE # 4885",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917231722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7216 BERGENLINE AVE # 1003",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070475489",
            "telephone_number": "973-320-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLAR CLINIC NJ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "WANG",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "415-343-5839"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fay Spragley, NP
• St. Joseph'S Pharmacy
• Kari Lynne Stahl, PHARM D
• Martin James Stedman, MD
• Aaron A Stein, MD
• Erica Michelle Stepansky, M.S. CCC-SLP
• Alan Michael Stephens, D.O.
• Marianne Stern
• Steven W. Braunstein MD
• STP Up-4 Developmental Disabilities

• Counselor in North Bergen, NJ
• Providers in North Bergen, NJ by specialty
• Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.