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General NPI Number Information
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NPI Number | 1326695271
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Entity Type | Organization
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Legal Business Name | STILL WATERS CONSULTING GROUP, LLC
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Dates
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Enumeration Date | 08/23/2019
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 505 W PERSHING BLVD STE C
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-2157
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Country | US
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Telephone | 501-500-0190
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Fax | 501-492-6495
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Provider Business Mailing Address
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Address Line | 505 W PERSHING BLVD STE C
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-2157
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Country | US
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Telephone | 501-500-0190
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Fax | 501-492-6495
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Authorized Official
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Title or Position | OWNER/LICENSED PSYCHOLOGIST
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Name | DR. CAREN R MOORE
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Credential | PHD
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Telephone | 501-500-0190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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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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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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