MEDICARE: STELLAR BEHAVIORAL HEALTH LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363L00000X	Nurse Practitioner
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
3	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
4	101YA0400X	Addiction (Substance Use Disorder) Counselor
5	324500000X	Substance Abuse Rehabilitation Facility
6	101YP2500X	Professional Counselor
7	1041C0700X	Clinical Social Worker
8	207RA0401X	Addiction Medicine (Internal Medicine) Physician

General Provider Information

NPI Number	:	1821870213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STELLAR BEHAVIORAL HEALTH LLC

Provider Business Mailing Address
First Line	:	7145 E VIRGINIA ST STE 2000
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-9147
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1718 ALEXANDRIA DR STE 102
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40504-3144
Country	:	US
Telephone Number	:	859-347-2412
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT ACKER
Credential	:
Telephone Number	:	812-962-7894

Provider Enumeration Date	:	10/19/2023
Last Update Date	:	01/17/2025

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