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General NPI Number Information
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NPI Number | 1396458071
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Entity Type | Organization
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Legal Business Name | STILL WATERS COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 12/28/2022
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Last Update Date | 12/28/2022
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Provider Practice Location Address
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Address Line | 4 SAINT MATTHEWS DR
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City | EDISON
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State | NJ
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Zip | 08817-3814
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Country | US
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Telephone | 732-515-5331
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Fax |
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Provider Business Mailing Address
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Address Line | 1789 LINCOLN HWY STE 109
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City | EDISON
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State | NJ
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Zip | 08817-3483
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ELIZABETH FRISINA
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Credential | LPC
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Telephone | 732-515-5331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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