Active NPI
Sheri Kay Stillwell, LCSW
- Clinical Social Worker
- Tyler, TX
National Provider Identifier
1154379832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 30239
- Practice address
- 1814 Roseland Blvd
Suite 200
Tyler, TX 75701-4234 - Phone
- (903) 531-2500
- Fax
- (903) 595-3785
- NPI assigned
- May 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 30239 | TX | Primary |
Addresses
Primary practice location
1814 Roseland Blvd
Suite 200
Tyler, TX 75701-4234
Mailing address
PO Box 130459
Tyler, TX 75713-0459
Phone (903) 531-2500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8K4353 | Other | TX | MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Texas Functional Medicine Center, LLC | Current | Accepting new patients | |
| Allied Pain Management Clinic P.a. | Clinical | Past | Accepting new patients |
| Allied Pain Management Clinic, P.a. | Clinical | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Public Health & General Preventive Medicine Physician
- Tyler, TX
- NPI 1245847672
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212364800000",
"number": "1154379832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 130459",
"city": "TYLER",
"state": "TX",
"postal_code": "757130459",
"telephone_number": "903-531-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1814 ROSELAND BLVD",
"address_2": "SUITE 200",
"city": "TYLER",
"state": "TX",
"postal_code": "757014234",
"telephone_number": "903-531-2500",
"fax_number": "903-595-3785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STILLWELL",
"first_name": "SHERI",
"middle_name": "KAY",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-04",
"last_updated": "2008-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TX",
"license": "30239",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "8K4353",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.