MEDICARE: STARRISING TELEHEALTH CLINIC PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1619811429
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STARRISING TELEHEALTH CLINIC PLLC

Provider Business Mailing Address
First Line	:	1150 KENTON DR
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-3072
Country	:	US
Telephone Number	:	619-313-1838
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 KENTON DR
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-3072
Country	:	US
Telephone Number	:	619-313-1838
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	IRENE ANSAH
Credential	:	LPC
Telephone Number	:	619-313-1838

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/15/2026

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