Provider Demographics
NPI:1225757529
Name:STILL OAK COUNSELING PLLC
Entity Type:Organization
Organization Name:STILL OAK COUNSELING PLLC
Other - Org Name:SILENTIUM, LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BODETT-DRESSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-354-8705
Mailing Address - Street 1:3833 E MAIN ST # 1002
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2424
Mailing Address - Country:US
Mailing Address - Phone:630-354-8705
Mailing Address - Fax:
Practice Address - Street 1:3833 E MAIN ST # 1002
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2424
Practice Address - Country:US
Practice Address - Phone:630-354-8705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)