Organization Active NPI

Stillwater Counseling Center

  • Group Psychotherapy Psychologist
  • Wauwatosa, WI
National Provider Identifier
1053474510
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
1881 Issued in WI
Legal business name
STILLWATER COUNSELING CENTER
Practice address
933 N Mayfair Rd
Suite 303
Wauwatosa, WI 53226-3432
Phone
(414) 456-9929
Fax
(414) 456-9994
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Helen M Ponec, LCSW MSW
Title
Co Director Psychotherapist
Phone
(414) 456-9929

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Group Psychotherapy PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TP2701X 1881 WI Primary

Addresses

Primary practice location

933 N Mayfair Rd
Suite 303
Wauwatosa, WI 53226-3432

Mailing address

933 N Mayfair Rd
Suite 303
Wauwatosa, WI 53226-3432
Phone (414) 456-9929

National Provider Directory

National Provider Directory

Locations

933 N Mayfair Rd
Ste 303
Wauwatosa, WI 53226
Phone (414) 258-8488

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1053474510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 N MAYFAIR RD",
            "address_2": "SUITE 303",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263432",
            "telephone_number": "414-456-9929",
            "fax_number": "414-456-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 N MAYFAIR RD",
            "address_2": "SUITE 303",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532263432",
            "telephone_number": "414-456-9929",
            "fax_number": "414-456-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "PONEC",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CO DIRECTOR PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "414-456-9929",
        "authorized_official_credential": "LCSW MSW"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "WI",
            "license": "1881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.