Provider Demographics
NPI:1730977950
Name:STILL WAVE THERAPY LLC
Entity type:Organization
Organization Name:STILL WAVE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:814-315-0047
Mailing Address - Street 1:410 CRANBERRY ST STE 220
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1090
Mailing Address - Country:US
Mailing Address - Phone:814-315-0047
Mailing Address - Fax:
Practice Address - Street 1:410 CRANBERRY ST STE 220
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1090
Practice Address - Country:US
Practice Address - Phone:814-315-0047
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-28
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty