Healthcare Provider Details

I. General information

NPI: 1992619506
Provider Name (Legal Business Name): STILLWATER BEHAVIORAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 COLE RD
CARNESVILLE GA
30521-4256
US

IV. Provider business mailing address

1445 COLE RD
CARNESVILLE GA
30521-4256
US

V. Phone/Fax

Practice location:
  • Phone: 706-498-6239
  • Fax:
Mailing address:
  • Phone: 706-498-6239
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: KATLYN KESLER
Title or Position: OWNER & EXECUTIVE DIRECTOR
Credential:
Phone: 706-498-6239