Organization Active NPI

Clear Star Wellness and Staffing LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterford, MI
National Provider Identifier
1942174107
Registry record updated Mar 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CLEAR STAR WELLNESS AND STAFFING LLC
Practice address
4515 Highland Rd Ste 800
Waterford, MI 48328-1132
Phone
(810) 884-6225
Fax
(313) 241-9386
NPI assigned
Oct 1, 2025
Last updated
Mar 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2026

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

Authorized official

Name
Ebere Agulanna, PMHNP-BC
Title
Member
Phone
(586) 925-6216

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

4515 Highland Rd Ste 800
Waterford, MI 48328-1132

Mailing address

4515 Highland Rd Ste 800
Waterford, MI 48328-1132
Phone (810) 884-6225

National Provider Directory

National Provider Directory

Locations

4515 Highland Rd
Ste 800
Waterford, MI 48328
Phone (810) 884-6225

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.

NPI Registry JSON

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

{
    "created_epoch": "1759276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772928000000",
    "number": "1942174107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 HIGHLAND RD STE 800",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281132",
            "telephone_number": "810-884-6225",
            "fax_number": "313-241-9386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 HIGHLAND RD STE 800",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281132",
            "telephone_number": "810-884-6225",
            "fax_number": "313-241-9386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR STAR WELLNESS AND STAFFING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-01",
        "last_updated": "2026-03-08",
        "certification_date": "2026-03-08",
        "status": "A",
        "authorized_official_last_name": "AGULANNA",
        "authorized_official_first_name": "EBERE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "586-925-6216",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2026; 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.