Provider Demographics
NPI:1700566692
Name:STILLWATERS COUNSELING AND CONSULTATION
Entity Type:Organization
Organization Name:STILLWATERS COUNSELING AND CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHRUMM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-527-2266
Mailing Address - Street 1:564 NE RAVENNA BLVD
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6460
Mailing Address - Country:US
Mailing Address - Phone:206-527-2266
Mailing Address - Fax:
Practice Address - Street 1:564 NE RAVENNA BLVD
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6460
Practice Address - Country:US
Practice Address - Phone:206-527-2266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty