Healthcare Provider Details

I. General information

NPI: 1922916451
Provider Name (Legal Business Name): STILL WATERS FAMILY COUNSELING SERVICES, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 W CALIFORNIA AVE
FRESNO CA
93706-3922
US

IV. Provider business mailing address

4460 W SHAW AVE STE 934
FRESNO CA
93722-6210
US

V. Phone/Fax

Practice location:
  • Phone: 559-795-0900
  • Fax: 559-795-0901
Mailing address:
  • Phone: 559-795-0900
  • Fax: 559-795-0901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. MICKIE VALENTINE
Title or Position: CEO
Credential: LMFT
Phone: 559-977-7554