Organization Active NPI

Stardust Therapy PLLC.

  • Clinical Social Worker
  • Skokie, IL
National Provider Identifier
1801765490
Registry record updated Nov 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
STARDUST THERAPY PLLC.
Practice address
9711 Skokie Blvd Ste H
Skokie, IL 60077-1384
Phone
(312) 800-1508
NPI assigned
Nov 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2025

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

Authorized official

Name
Stephanie Kaloustian, BA, MSW, LCSWNPI 1710622691
Title
Licensed Clinical Social Worker
Phone
(312) 800-1508

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

9711 Skokie Blvd Ste H
Skokie, IL 60077-1384

Mailing address

9711 Skokie Blvd Ste H
Skokie, IL 60077-1384
Phone (312) 800-1508

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1761955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761955200000",
    "number": "1801765490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9711 SKOKIE BLVD STE H",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771384",
            "telephone_number": "312-800-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9711 SKOKIE BLVD STE H",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771384",
            "telephone_number": "312-800-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STARDUST THERAPY PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-01",
        "last_updated": "2025-11-01",
        "certification_date": "2025-11-01",
        "status": "A",
        "authorized_official_last_name": "KALOUSTIAN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "312-800-1508",
        "authorized_official_credential": "BA, MSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.