Organization Active NPI

Stages Family Therapy and Wellness Center, Inc.

  • Adult Mental Health Clinic/Center
  • Camarillo, CA
National Provider Identifier
1639983208
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
Legal business name
STAGES FAMILY THERAPY AND WELLNESS CENTER, INC.
Practice address
1317 Del Norte Rd Ste 200
Camarillo, CA 93010-8368
Phone
(805) 415-2441
NPI assigned
Feb 4, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Authorized official

Name
Kerry Costello, MFTNPI 1285385849
Title
President
Phone
(805) 415-2441

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X Primary

Addresses

Primary practice location

1317 Del Norte Rd Ste 200
Camarillo, CA 93010-8368

Mailing address

44 Duvali Dr
Ventura, CA 93003-2151
Phone (805) 415-2441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250630003163 CA Part B Supplier - Clinic/Group Practice 9638682982 Receives reassigned benefits from 2 practitioners
Practice locations: Camarillo, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1738627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773964800000",
    "number": "1639983208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 DUVALI DR",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930032151",
            "telephone_number": "805-415-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 DEL NORTE RD STE 200",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930108368",
            "telephone_number": "805-415-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAGES FAMILY THERAPY AND WELLNESS CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-04",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "KERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-415-2441",
        "authorized_official_credential": "MFT"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; 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.