Stillwater Psychological Associates PA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12610 Issued in MN

Legal business name

STILLWATER PSYCHOLOGICAL ASSOCIATES PA

Practice address

1611 County Road B W Ste 102
Roseville, MN 55113-4053

Phone

(651) 356-4436

Fax

(651) 348-8349

NPI assigned

Sep 30, 2015

Organization subpart

Yes

Parent organization

PARTNERS IN RECOVERY, LLC.As reported in NPPES

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

Authorized official

Name

Christopher McCalla

Title

Owner

Phone

(651) 356-4436

Specialties & licenses 1

Addresses

Part of

Partners in Recovery LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Partners in Recovery, LLC

  dba Partners Behavioral Healthcare

  • Community/Behavioral Health Agency
  • Saint Paul, MN
  • NPI 1194080234
  NPPES parent name

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

{
    "created_epoch": "1443571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444176000000",
    "number": "1265802532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W STE 102",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134053",
            "telephone_number": "651-356-4436",
            "fax_number": "651-348-8349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W STE 102",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134053",
            "telephone_number": "651-356-4436",
            "fax_number": "651-348-8349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER PSYCHOLOGICAL ASSOCIATES PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PARTNERS IN RECOVERY, LLC.",
        "enumeration_date": "2015-09-30",
        "last_updated": "2015-10-07",
        "status": "A",
        "authorized_official_last_name": "MCCALLA",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-356-4436"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "12610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heidi Steinle, MS, CCC-SLP
• Marissa Joelle Stelzer, LPCC
• Kaili Jean Stevens, LADC
• Laura Stewart, PHARMD
• Phillip Charles Stewart, P.A.-C
• Anne Stocker, PHD, LP
• Isabelle Stoffel
• Matthew Jacob Stolzberg, MD
• Robert M Storevik, P.T.
• Karin Leigh Stoutenburg, D.C.

• Clinical Social Worker in Roseville, MN
• Providers in Roseville, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.