Provider Demographics
NPI:1972859593
Name:STILLWATER COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:STILLWATER COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOON
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:509-925-1840
Mailing Address - Street 1:1206 N DOLARWAY RD
Mailing Address - Street 2:203
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-8392
Mailing Address - Country:US
Mailing Address - Phone:509-925-1840
Mailing Address - Fax:
Practice Address - Street 1:1206 N DOLARWAY RD
Practice Address - Street 2:203
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-8392
Practice Address - Country:US
Practice Address - Phone:509-925-1840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60219078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty