STILLWATERS COUNSELING LLC NPI 1275638645

NPI Information

NPI: 1275638645
Provider Name: STILLWATERS COUNSELING LLC
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
1309 CAMAS ST
BLACKFOOT, ID
ZIP 83221
Phone: (208) 782-0675
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STILLWATERS COUNSELING LLC is a mental health counselor in Blackfoot, ID. STILLWATERS COUNSELING LLC NPI is 1275638645. The provider is registered as an organization entity type.

The provider's business location address is:

1309 CAMAS ST
BLACKFOOT, ID
ZIP 83221-060
Phone: (208) 782-0675
Fax: (208) 782-0678

The provider's authorized official is John D Stephenson .
The authorized official title is Owner/therapist and has the following contact phone number (208) 782-0675.

The enumeration date for this NPI number is 9/13/2006 and was last updated on 8/4/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251B00000X	Case Management		LCSW-261187	IDAHO	No
2	101YM0800X	Counselor	Mental Health	LCSW-261187	IDAHO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	806939500	MEDICAID	IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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