Organization Active NPI

Still Waters Psychiatry, LLC

  • Clinical Psychologist
  • East Providence, RI
National Provider Identifier
1104713536
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
STILL WATERS PSYCHIATRY, LLC
Practice address
197 Warren Ave Ste 101
East Providence, RI 02914-4826
Phone
(401) 238-0776
Fax
(401) 757-8688
NPI assigned
Jun 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Authorized official

Name
Emily Daniell, NPNPI 1134657505
Title
Owner
Phone
(251) 533-1424

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

197 Warren Ave Ste 101
East Providence, RI 02914-4826

Mailing address

197 Warren Ave Ste 101
East Providence, RI 02914-4826
Phone (401) 238-0776

Other names 1

  • Still Waters Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250801002586 RI Part B Supplier - Clinic/Group Practice 3577071430 Receives reassigned benefits from 2 practitioners
Practice locations: East Providence, RI

National Provider Directory

National Provider Directory

Locations

197 Warren Ave
Ste 101
East Providence, RI 02914
Phone (401) 238-0776

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751932800000",
    "number": "1104713536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 WARREN AVE STE 101",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029144826",
            "telephone_number": "401-238-0776",
            "fax_number": "401-757-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 WARREN AVE STE 101",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029144826",
            "telephone_number": "401-238-0776",
            "fax_number": "401-757-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILL WATERS PSYCHIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-19",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A",
        "authorized_official_last_name": "DANIELL",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "251-533-1424",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Still Waters Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.