Active NPI
Stella Marie Mantakos, LCPC
- Professional Counselor
- Joppa, MD
National Provider Identifier
1619777869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LC7178
- Practice address
- 1300 Old Joppa Rd
Joppa, MD 21085-3316 - Phone
- (443) 963-7800
- NPI assigned
- Mar 17, 2025
- Last updated
- Mar 17, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LC7178 | MD | Primary |
Addresses
Primary practice location
1300 Old Joppa Rd
Joppa, MD 21085-3316
Mailing address
1300 Old Joppa Rd
Joppa, MD 21085-3316
Phone (443) 963-7800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grow Healthcare Group PA | Professional | Current | Accepting new patients |
Locations
66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711
8300 Boone Blvd
Ste 500
Vienna, VA 22182
Phone (703) 884-2598
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742169600000",
"number": "1619777869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 OLD JOPPA RD",
"city": "JOPPA",
"state": "MD",
"postal_code": "210853316",
"telephone_number": "443-963-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 OLD JOPPA RD",
"city": "JOPPA",
"state": "MD",
"postal_code": "210853316",
"telephone_number": "443-963-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANTAKOS",
"first_name": "STELLA",
"middle_name": "MARIE",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-17",
"last_updated": "2025-03-17",
"certification_date": "2025-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC7178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Joppa, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.