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NPI Code Detail

MEDICARE: STILL WATERS COUNSELING CENTER, LLC

MEDICARE: STILL WATERS COUNSELING CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor

General Provider Information

NPI Number : 1003563917
Entity Type Code : Organization
Provider Name (Legal Business Name) : STILL WATERS COUNSELING CENTER, LLC
Provider Business Mailing Address
First Line : 400 OFFICE PARK DR STE 230
Second Line :
City : MOUNTAIN BRK
State : AL
Zip : 35223-3410
Country : US
Telephone Number : 205-883-1423
Fax Number :
Provider Business Practice Location Address
First Line : 400 OFFICE PARK DR STE 230
Second Line :
City : MOUNTAIN BRK
State : AL
Zip : 35223-3410
Country : US
Telephone Number : 205-883-1423
Fax Number : 205-533-9960
Authorized Official
Title or Position : LICENSED PROFESSIONAL COUNSELOR
Name : MRS. BEVERLY WARD
Credential : MA, EDS, LPC
Telephone Number : 205-825-1423
Provider Enumeration Date : 03/10/2022
Last Update Date : 12/15/2024

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