Healthcare Provider Details

I. General information

NPI: 1326991670
Provider Name (Legal Business Name): GLOWING STARS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WEST RD STE 300
TOWSON MD
21204-2370
US

IV. Provider business mailing address

100 WEST RD STE 300
TOWSON MD
21204-2370
US

V. Phone/Fax

Practice location:
  • Phone: 732-216-6787
  • Fax:
Mailing address:
  • Phone: 732-216-6787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ARIEL DAVID VISHNEVSKY
Title or Position: PARTNER
Credential:
Phone: 732-216-6787