Mia Tanya Stula Kellam, LAC
Counselor, Mental Health in Bound Brook, New Jersey
1417114240- Practice location
- 339 W 2ND St, Bound Brook, NJ 08805-1833
- Phone
- 732-356-1082
- Fax
- 732-356-6327
- Last updated
- May 20, 2008
Mia Tanya Stula Kellam is a Counselor, Mental Health based in Bound Brook, NJ. Mia Tanya Stula Kellam practices in Bound Brook, NJ and has the professional credentials of LAC. The NPI Number for Mia Tanya Stula Kellam is 1417114240 and holds a License No. 37AC00041700 (NJ). The current practice location address for Mia Tanya Stula Kellam is 339 W 2ND St, Bound Brook, NJ 08805-1833 and can be reached out via phone at 732-356-1082 and via fax at 732-356-6327.
Provider Profile Details
- NPI Number
- 1417114240
- Provider Name
- Mia Tanya Stula Kellam
- Credential
- LAC
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 339 W 2ND St, Bound Brook, NJ 08805-1833
- Phone Number
- 732-356-1082
- Fax Number
- 732-356-6327
- Primary Taxonomy
- Counselor, Mental Health · 101YM0800X
- Sole Proprietor
- No
- Provider Enumeration Date
- May 20, 2008
- Last Update Date
- May 20, 2008
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 339 W 2ND St
Bound Brook, NJ 08805-1833 - City
- Bound Brook
- State
- New Jersey
- Zip
- 08805-1833
- Phone Number
- 732-356-1082
- Fax Number
- 732-356-6327
Provider Business Mailing Address Details
- Address
- 339 W 2ND St
Bound Brook, NJ 08805-1833 - City
- Bound Brook
- State
- NJ
- Zip
- 08805-1833
- Phone Number
- 732-356-1082
- Fax Number
- 732-356-6327
License Information
- License Number
- 37AC00041700
- License State
- NJ
- Taxonomy
- Counselor, Mental Health · 101YM0800X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Counselor, Mental Health providers near Bound Brook, NJ
View all Counselor, Mental Health providers in Bound Brook →- Andrze Mazan, LCADC, CSWCounselor, Mental Health · NPI 1710048244
- Carmela Gutierrez, LPCCounselor, Mental Health · NPI 1437219946
- Claire Roberts, LSWCounselor, Mental Health · NPI 1528129079
- Craig Haft, LSWCounselor, Mental Health · NPI 1548320062
- Dr. Kevin M Enright, PHD, LPCCounselor, Mental Health · NPI 1609949239
- Heather Cooper Barry, LSWCounselor, Mental Health · NPI 1144493313
Frequently Asked Questions
What is the NPI number of Mia Tanya Stula Kellam, LAC?
The NPI number of Mia Tanya Stula Kellam, LAC is 1417114240. It was assigned on May 20, 2008 and is currently active in the NPPES registry.
What is the specialty of Mia Tanya Stula Kellam, LAC?
Mia Tanya Stula Kellam, LAC is registered under the primary taxonomy Counselor, Mental Health (code 101YM0800X), licensed in NJ under license number 37AC00041700.
Where does Mia Tanya Stula Kellam, LAC practice?
The practice location is 339 W 2ND St, Bound Brook, NJ 08805-1833. The office can be reached at 732-356-1082 (phone) or 732-356-6327 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1417114240 directly on the NPPES registry website.