Healthcare Provider Details

I. General information

NPI: 1669268538
Provider Name (Legal Business Name): CAMELLIA COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 BROADWAY BACK BUILDING, SUITE 103
WOODCLIFF LAKE NJ
07677
US

IV. Provider business mailing address

172 BROADWAY BACK BUILDING, SUITE 103
WOODCLIFF LAKE NJ
07677
US

V. Phone/Fax

Practice location:
  • Phone: 201-373-2282
  • Fax:
Mailing address:
  • Phone: 201-373-2282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: REBECCA STEGMANN
Title or Position: OWNER
Credential: MA, LPC
Phone: 201-373-2282