Healthcare Provider Details

I. General information

NPI: 1700711108
Provider Name (Legal Business Name): STUBER COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 JANCAROL CT
KOKOMO IN
46901-1897
US

IV. Provider business mailing address

1203 JANCAROL CT
KOKOMO IN
46901-1897
US

V. Phone/Fax

Practice location:
  • Phone: 765-319-9488
  • Fax:
Mailing address:
  • Phone: 765-319-9488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: NICOLE STUBER
Title or Position: MENTAL HEALTH COUNSELOR
Credential: MA, LMHC
Phone: 765-319-9488