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General NPI Number Information
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NPI Number | 1568931202
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Entity Type | Individual
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Provider Name | DANIEL H STILLWELL PHD, LMFT
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Gender | Male
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Dates
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Enumeration Date | 11/23/2018
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Last Update Date | 11/23/2018
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Provider Practice Location Address
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Address Line | 1515 MOCKINGBIRD LN STE 540
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City | CHARLOTTE
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State | NC
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Zip | 28209-3297
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Country | US
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Telephone | 980-552-0083
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Fax |
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Provider Business Mailing Address
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Address Line | 1935 E WOODLAWN RD APT C
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City | CHARLOTTE
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State | NC
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Zip | 28209-2241
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Country | US
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Telephone | 859-509-7088
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1788
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License Number State | NC
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