Stillwater Family Therapy Group, Inc.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

STILLWATER FAMILY THERAPY GROUP, INC.

Practice address

4727 W 164TH St
Lawndale, CA 90260-2824

Phone

(310) 378-2520

NPI assigned

Dec 17, 2021

Last updated

Dec 17, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Virginia Green, LMFTNPI 1295872455

Title

Ceo

Phone

(310) 378-2520

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Practitioners 1

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.

• Virginia C. Green, PHD

  • Mental Health Counselor
  • Lawndale, CA
  • NPI 1295872455
  NPD Authorized official

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

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1366102337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4727 W 164TH ST",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902602824",
            "telephone_number": "310-378-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4727 W 164TH ST",
            "city": "LAWNDALE",
            "state": "CA",
            "postal_code": "902602824",
            "telephone_number": "310-378-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILLWATER FAMILY THERAPY GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-17",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-378-2520",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11702210",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.stillwaterfamilytherapy.com",
            "affiliation": "N",
            "endpointDescription": "URL",
            "address_1": "4727 W 164th St",
            "city": "Lawndale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902602824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.stillwaterfamilytherapy.com",
            "affiliation": "N",
            "endpointDescription": "URL",
            "address_1": "4727 W 164th St",
            "city": "Lawndale",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902602824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Marriage & Family Therapist in Lawndale, CA
• Providers in Lawndale, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.