Healthcare Provider Details

I. General information

NPI: 1861378341
Provider Name (Legal Business Name): STILL WATERS CHRISTIAN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E 7TH ST STE 154
HAYS KS
67601-4907
US

IV. Provider business mailing address

3206 WILLOW ST
HAYS KS
67601-1727
US

V. Phone/Fax

Practice location:
  • Phone: 785-734-0447
  • Fax: 620-805-6933
Mailing address:
  • Phone: 719-289-8743
  • Fax: 785-734-0447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: REBECCA S CLARK
Title or Position: CEO/THERAPIST
Credential: LSCSW
Phone: 719-289-8743