Provider Demographics
NPI:1932878386
Name:STILL WATERS COUNSELLING LLC
Entity Type:Organization
Organization Name:STILL WATERS COUNSELLING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WORDHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, CCATP-CA
Authorized Official - Phone:703-328-7135
Mailing Address - Street 1:13919 SPRINGSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:VA
Mailing Address - Zip Code:20124-2343
Mailing Address - Country:US
Mailing Address - Phone:703-328-7135
Mailing Address - Fax:
Practice Address - Street 1:13919 SPRINGSTONE DR
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:VA
Practice Address - Zip Code:20124-2343
Practice Address - Country:US
Practice Address - Phone:703-328-7135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-09
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty