Provider Demographics
NPI:1861664476
Name:STILL WATERS COUNSELING, INC
Entity Type:Organization
Organization Name:STILL WATERS COUNSELING, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:BRANNON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:828-612-8064
Mailing Address - Street 1:PO BOX 6337
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28603-6403
Mailing Address - Country:US
Mailing Address - Phone:828-612-8064
Mailing Address - Fax:
Practice Address - Street 1:400 MAIN ST W
Practice Address - Street 2:
Practice Address - City:VALDESE
Practice Address - State:NC
Practice Address - Zip Code:28690
Practice Address - Country:US
Practice Address - Phone:828-612-8064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-24
Last Update Date:2018-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5070101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty