Provider Demographics
NPI:1225522279
Name:STILLWELL, SHAWNA (IMFT MA)
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:
Last Name:STILLWELL
Suffix:
Gender:F
Credentials:IMFT MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 SCHOOL AVE
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-4149
Mailing Address - Country:US
Mailing Address - Phone:614-886-3577
Mailing Address - Fax:234-274-8294
Practice Address - Street 1:2101 FRONT ST STE 200B
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3251
Practice Address - Country:US
Practice Address - Phone:216-307-4229
Practice Address - Fax:234-274-8294
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHF.2000147106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist