Healthcare Provider Details

I. General information

NPI: 1205462348
Provider Name (Legal Business Name): STILLPOINT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 09/23/2020
Certification Date: 09/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 NORTH GRANBY ROAD
NORTH GRANBY CT
06060
US

IV. Provider business mailing address

369 NORTH GRANBY ROAD
NORTH GRANBY CT
06060
US

V. Phone/Fax

Practice location:
  • Phone: 860-650-1651
  • Fax: 860-413-0981
Mailing address:
  • Phone: 860-650-1651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE LOUISE BICKING
Title or Position: CEO
Credential: JP LCSW MPA CD/DONA
Phone: 860-650-1651