Organization Active NPI

Still Waters Therapy, Marriage and Family Counseling, PC

  • Marriage & Family Therapist
  • Elk Grove, CA
National Provider Identifier
1487337432
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
STILL WATERS THERAPY, MARRIAGE AND FAMILY COUNSELING, PC
Practice address
9401 E Stockton Blvd Ste 115
Elk Grove, CA 95624-5050
Phone
(916) 579-7145
Fax
(916) 581-8694
NPI assigned
Aug 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Makela Nicole Mims, LMFT
Title
Owner
Phone
(916) 579-7145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X Primary

Addresses

Primary practice location

9401 E Stockton Blvd Ste 115
Elk Grove, CA 95624-5050

Mailing address

9401 E Stockton Blvd Ste 115
Elk Grove, CA 95624-5050
Phone (916) 579-7145

Other names 1

  • Still Waters Therapy, Marriage and Family Counseling, PC Other name

National Provider Directory

National Provider Directory

Locations

9401 E Stockton Blvd
Ste 115
Elk Grove, CA 95624
Phone (916) 359-2950

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": "1691452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1487337432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9401 E STOCKTON BLVD STE 115",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245050",
            "telephone_number": "916-579-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9401 E STOCKTON BLVD STE 115",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956245050",
            "telephone_number": "916-579-7145",
            "fax_number": "916-581-8694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILL WATERS THERAPY, MARRIAGE AND FAMILY COUNSELING, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "MAKELA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-579-7145",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Still Waters Therapy, Marriage and Family Counseling, PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.