=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255894903
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STILL MOTION THERAPEUTIC SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2019
-----------------------------------------------------
Last Update Date | 11/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 16 EASTMAN ST
-----------------------------------------------------
City | DORCHESTER
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02125-3891
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-858-8017
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 207 WASHINGTON ST
-----------------------------------------------------
City | BROOKLINE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 02445-6866
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 617-858-8017
-----------------------------------------------------
Fax | 617-207-9709
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MARIA ELENA MEIDANIS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 617-858-8017
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------