Provider Demographics
NPI:1003535808
Name:STILL POINT PSYCHOTHERAPY & WELLNESS LLC
Entity Type:Organization
Organization Name:STILL POINT PSYCHOTHERAPY & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:F
Authorized Official - Last Name:BERNARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-918-8087
Mailing Address - Street 1:12 EQUESTRIAN CT
Mailing Address - Street 2:
Mailing Address - City:TIJERAS
Mailing Address - State:NM
Mailing Address - Zip Code:87059-7621
Mailing Address - Country:US
Mailing Address - Phone:505-901-8087
Mailing Address - Fax:
Practice Address - Street 1:12 EQUESTRIAN CT
Practice Address - Street 2:
Practice Address - City:TIJERAS
Practice Address - State:NM
Practice Address - Zip Code:87059-7621
Practice Address - Country:US
Practice Address - Phone:505-901-8087
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)