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MIA TANYA STULA KELLAM LAC
NPI 1417114240
Counselor - Mental Health in Bound Brook, NJ

Active since May 20, 2008
339 W 2ND ST, BOUND BROOK, NJ 08805(732) 356-1082(732) 356-6327 Get Directions Write a Review

NPPES record last updated: May 20, 2008. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mia Tanya Stula Kellam Lac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIA TANYA STULA KELLAM LAC (NPI 1417114240) is an individual mental health provider in Bound Brook, New Jersey, licensed in New Jersey (37AC00041700) and active in the NPI registry since May 2008.

NPPES Registry Identity

NPI1417114240
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMIA TANYA STULA KELLAMCredential: LAC
Location Address339 W 2ND STBound Brook, NJ 08805-1833
Mailing Address339 W 2nd StBound Brook, NJ 08805-1833 · (732) 356-1082 · Fax (732) 356-6327
Phone(732) 356-1082
Fax(732) 356-6327
Sole ProprietorNo
Enumeration DateMay 20, 2008
✔ NPI 1417114240 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NJ · 37AC00041700
339 W 2ND ST, Bound Brook, NJ 08805
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE L SIMMONS LSW
Social Worker
339 W 2ND ST
BOUND BROOK, NJ 08805
Somerset County (732) 356-1082
KATHY MEGROZ FOLEY LCSW
Social Worker (Clinical)
339 W 2ND ST
BOUND BROOK, NJ 08805
Somerset County (732) 356-1082
MICHELE WADSWORTH LSW
Social Worker
339 W 2ND ST
BOUND BROOK, NJ 08805
Somerset County (732) 356-1082
MEREDITH REEDY LSW
Social Worker
339 W 2ND ST
BOUND BROOK, NJ 08805
Somerset County (732) 356-1082
DONNA PUGLIA LCADC
Counselor (Addiction (Substance Use Disorder))
339 W 2ND ST
BOUND BROOK, NJ 08805
Somerset County (732) 356-1082
IVELISSE A REYES
Counselor (Professional)
339 W 2ND ST
BOUND BROOK, NJ 08805
Somerset County (732) 356-1082
HEATHER COOPER BARRY LSW
Counselor (Mental Health)
339 W 2ND ST
BOUND BROOK, NJ 08805
Somerset County (732) 356-1082
JOANNE SCHIEBLER LCSW
Social Worker (Clinical)
339 W 2ND ST
BOUND BROOK, NJ 08805
Somerset County (732) 356-1082

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mia Tanya Stula Kellam's NPI number?

The NPI number for Mia Tanya Stula Kellam is 1417114240. It was assigned to this individual provider in the NPPES registry on May 20, 2008.

Where is Mia Tanya Stula Kellam located?

Mia Tanya Stula Kellam practices at 339 W 2nd St, Bound Brook, NJ 08805. The listed phone number is (732) 356-1082.

What is Mia Tanya Stula Kellam's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Mia Tanya Stula Kellam was last updated on May 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.