Active NPI
Stars of Wellness
- Psychologist
- Sarasota, FL
National Provider Identifier
1710279617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301013176
- Legal business name
- STARS OF WELLNESS
- Practice address
- 10179 Milky Way Cir
Sarasota, FL 34241-1503 - Phone
- (586) 262-4153
- NPI assigned
- May 10, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Laurie Burda Mastrogianis, PHD
- Title
- Director
- Phone
- (586) 262-4153
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301013176 | MI | Primary |
Addresses
Primary practice location
10179 Milky Way Cir
Sarasota, FL 34241-1503
Mailing address
10179 Milky Way Cir
Sarasota, FL 34241-1503
Phone (586) 262-4153
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0E03190 | Other | MI | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryLocations
1000 W University Dr
Ste 104
Rochester, MI 48307
Phone (586) 540-1094
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Professional Counselor
- Rochester, MI
- NPI 1902182884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304985600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693440000000",
"number": "1710279617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10179 MILKY WAY CIR",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342411503",
"telephone_number": "586-262-4153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10179 MILKY WAY CIR",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342411503",
"telephone_number": "586-262-4153"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STARS OF WELLNESS",
"organizational_subpart": "NO",
"enumeration_date": "2011-05-10",
"last_updated": "2023-08-31",
"certification_date": "2023-08-31",
"status": "A",
"authorized_official_last_name": "MASTROGIANIS",
"authorized_official_first_name": "LAURIE",
"authorized_official_middle_name": "BURDA",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "586-262-4153",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "MI",
"license": "6301013176",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0E03190",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.