Provider Demographics
NPI:1275132193
Name:CATRINA STILLER, LLC
Entity Type:Organization
Organization Name:CATRINA STILLER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:STILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCMH
Authorized Official - Phone:302-569-9832
Mailing Address - Street 1:19266 COASTAL HWY
Mailing Address - Street 2:UNIT 4 #29
Mailing Address - City:REHOBOTH BEACH
Mailing Address - State:DE
Mailing Address - Zip Code:19971
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1632 SAVANNAH RD STE 9
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1659
Practice Address - Country:US
Practice Address - Phone:302-569-9832
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health