Provider Demographics
NPI:1851726251
Name:STILLWELL, SATCHEL PIERCE (BA, MA, LPC-I)
Entity Type:Individual
Prefix:
First Name:SATCHEL
Middle Name:PIERCE
Last Name:STILLWELL
Suffix:
Gender:M
Credentials:BA, MA, LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1450 S WHITE CHAPEL BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-9306
Mailing Address - Country:US
Mailing Address - Phone:817-917-8843
Mailing Address - Fax:
Practice Address - Street 1:181 GRAND AVE
Practice Address - Street 2:STE 230
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-7631
Practice Address - Country:US
Practice Address - Phone:817-756-1440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX71276101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27-2486022OtherEIN