MEDICARE: STILLPOINT, INC

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
1	1041C0700X	Clinical Social Worker	0904-000561	VA

General Provider Information

NPI Number	:	1407094709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STILLPOINT, INC

Provider Business Mailing Address
First Line	:	5701 PRINCESS ANNE RD
Second Line	:	SUITE 101
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3253
Country	:	US
Telephone Number	:	757-490-5665
Fax Number	:	757-490-9735

Provider Business Practice Location Address
First Line	:	5701 PRINCESS ANNE RD
Second Line	:	SUITE 101
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23462-3253
Country	:	US
Telephone Number	:	757-490-5665
Fax Number	:	757-490-9735

Authorized Official
Title or Position	:	ASSOCIATE DIRECTOR
Name	:	MR. PETER BARNETT
Credential	:	LCSW
Telephone Number	:	757-490-5665

Provider Enumeration Date	:	01/26/2009
Last Update Date	:	01/26/2009

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Directions to “STILLPOINT, INC ” Practice Location

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