NPIMap

Organization Active NPI

Stillwater LLC

  • Mental Health Counselor
  • Morgantown, WV
National Provider Identifier
1124647193
Registry record updated Aug 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
STILLWATER LLC
Practice address
933 Cheat Rd
Morgantown, WV 26508-5631
Phone
(304) 216-7779
NPI assigned
Apr 10, 2020
Last updated
Aug 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2020

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

Authorized official

Name
Christine Knight
Title
Office Manager
Phone
(304) 554-2292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

933 Cheat Rd
Morgantown, WV 26508-5631

Mailing address

933 Cheat Rd
Morgantown, WV 26508-5631
Phone (304) 554-2292

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200810003249 WV Part B Supplier - Clinic/Group Practice 4587089305 Receives reassigned benefits from 11 practitioners
Practice locations: Morgantown, WV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1124647193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 CHEAT RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265085631",
            "telephone_number": "304-554-2292",
            "fax_number": "304-554-2249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 CHEAT RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265085631",
            "telephone_number": "304-216-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-554-2292"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.