Organization Active NPI

Stillwater Christian Counseling PLLC

  • Psychologist
  • Kingwood, WV
National Provider Identifier
1336215268
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
STILLWATER CHRISTIAN COUNSELING PLLC
Practice address
130 S Price St
Suite 204
Kingwood, WV 26537-1462
Phone
(304) 329-1900
Fax
(304) 329-1050
NPI assigned
Nov 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Alfred Ludwig Kasprowicz, PH.D.NPI 1225104177
Title
Manager Sole Practitioner
Phone
(304) 329-1900

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

130 S Price St
Suite 204
Kingwood, WV 26537-1462

Mailing address

130 S Price St
Suite 204
Kingwood, WV 26537-1462
Phone (304) 329-1900

Other identifiers 1

IdentifierTypeStateIssuer
0164483000MedicaidWV

National Provider Directory

National Provider Directory

Locations

130 S Price St
Ste 204
Kingwood, WV 26537
Phone (304) 329-1900

Practitioners & affiliated clinicians

Practitioners 1

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": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336215268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 S PRICE ST",
            "address_2": "SUITE 204",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371462",
            "telephone_number": "304-329-1900",
            "fax_number": "304-329-1050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S PRICE ST",
            "address_2": "SUITE 204",
            "city": "KINGWOOD",
            "state": "WV",
            "postal_code": "265371462",
            "telephone_number": "304-329-1900",
            "fax_number": "304-329-1050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER CHRISTIAN COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KASPROWICZ",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_middle_name": "LUDWIG",
        "authorized_official_title_or_position": "MANAGER SOLE PRACTITIONER",
        "authorized_official_telephone_number": "304-329-1900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0164483000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingwood, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.