Provider Demographics
NPI:1114314697
Name:STILLPOINT COUNSELING
Entity Type:Organization
Organization Name:STILLPOINT COUNSELING
Other - Org Name:STILLPOINT COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOOZH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:415-496-6772
Mailing Address - Street 1:2811 COLLEGE AVE UNIT A
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2167
Mailing Address - Country:US
Mailing Address - Phone:415-496-6772
Mailing Address - Fax:
Practice Address - Street 1:2811 COLLEGE AVE UNIT A
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2167
Practice Address - Country:US
Practice Address - Phone:415-496-6772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-22
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24755103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1437517265OtherNPI
CA1841554169OtherNPI