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General NPI Number Information
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NPI Number | 1003563917
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Entity Type | Organization
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Legal Business Name | STILL WATERS COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 03/10/2022
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Last Update Date | 12/15/2024
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Provider Practice Location Address
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Address Line | 400 OFFICE PARK DR STE 230
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City | MOUNTAIN BRK
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State | AL
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Zip | 35223-3410
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Country | US
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Telephone | 205-883-1423
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Fax | 205-533-9960
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Provider Business Mailing Address
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Address Line | 400 OFFICE PARK DR STE 230
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City | MOUNTAIN BRK
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State | AL
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Zip | 35223-3410
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Country | US
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Telephone | 205-883-1423
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MRS. BEVERLY WARD
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Credential | MA, EDS, LPC
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Telephone | 205-825-1423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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