Star Therapy

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

STAR THERAPY

Practice address

4470 W 78TH Street Cir
Bloomington, MN 55435-5408

Phone

(770) 713-7467

NPI assigned

Jun 27, 2025

Organization subpart

No

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

Authorized official

Name

Mouktar BouralehNPI 1467341297

Title

Owner/Manager

Phone

(770) 713-7467

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Mouktar Bouraleh

  • Behavior Analyst
  • Bloomington, MN
  • NPI 1467341297
  NPD Authorized official

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

{
    "created_epoch": "1750982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750982400000",
    "number": "1669361499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 HUMBOLDT AVE S # 402",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311433",
            "telephone_number": "770-713-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4470 W 78TH STREET CIR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554355408",
            "telephone_number": "770-713-7467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAR THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-27",
        "last_updated": "2025-06-27",
        "certification_date": "2025-06-27",
        "status": "A",
        "authorized_official_last_name": "BOURALEH",
        "authorized_official_first_name": "MOUKTAR",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "770-713-7467"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Lynn Stadler
• Annie Marie Stafford, LADC
• Benjamin Frederick Stagg, OTR/L
• Laine Stanton
• Star Supportive Services, LLC.
• Elizabeth Jane Honey Stark, LICSW
• Jolene Stark, LADC
• Jennifer Ruth Starks, MA, LMFT
• State of Minnesota DHS
• Christina Stavig, DO

• Community/Behavioral Health Agency in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.