Provider Demographics
NPI:1497105241
Name:STILL COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:STILL COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STILL
Authorized Official - Suffix:
Authorized Official - Credentials:M ED, LPC, NCC
Authorized Official - Phone:901-258-8147
Mailing Address - Street 1:402 RIDGEWOOD MANOR DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-2906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1202 OFFICE PARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5267
Practice Address - Country:US
Practice Address - Phone:901-258-8147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1270251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health