Provider Demographics
NPI:1770383572
Name:STILL WATERS THERAPY LLC
Entity type:Organization
Organization Name:STILL WATERS THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:W
Authorized Official - Last Name:MADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-227-7896
Mailing Address - Street 1:5007 LEEDS MANOR RD
Mailing Address - Street 2:
Mailing Address - City:MARKHAM
Mailing Address - State:VA
Mailing Address - Zip Code:22643-1937
Mailing Address - Country:US
Mailing Address - Phone:540-227-7896
Mailing Address - Fax:
Practice Address - Street 1:4372 OLD TAVERN RD.
Practice Address - Street 2:
Practice Address - City:THE PLAINS
Practice Address - State:VA
Practice Address - Zip Code:20198
Practice Address - Country:US
Practice Address - Phone:540-227-7896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty