Tina Stillwell, LSCSW
Individual provider Active NPI Clinical Social Worker · Clay Center, KS
NPI 1609004456 · NPPES record last updated Nov 10, 2022
Key facts
- NPI
- 1609004456
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 80-057-2059 (KS)
- Practice address
- 619 Court St
Clay Center, KS 67432-2607 - Phone
- (785) 630-5500
- Fax
- (785) 630-5295
- NPI assigned
- Jun 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
619 Court St
Clay Center, KS 67432-2607
Phone (785) 630-5500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100816000710 | KS | Practitioner - Clinical Social Worker | 4385778182 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tina Stillwell Lscsw, LLC | Clinical | Current |
Accepting new patients |
| Mellies Mental Wellness LLC | Current |
Accepting new patients |
Locations
619 Court St
Clay Center, KS 67432
Phone (785) 630-5500
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 80-057-2059 | KS | Yes |
Addresses
Primary practice location
619 Court St
Clay Center, KS 67432-2607
Mailing address
619 Court St
Clay Center, KS 67432-2607
Phone (785) 630-5500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200656790A | Medicaid | KS | |
| 200656790A | Other | KS | MEDICAID |
| KA1795 | Medicaid | KS |
Other names
- Tina Marie Walsh
Other providers in Clay Center, KS
- Dianne Marie Smith
- Brent V Snyder
- Special Delivery LLC
- Courtnee Lynn Spillman
- Laura Sue Squires
- Jaacob Leigh Struffert
- Kayla Sulanka
- Susan D. Thompson
- Tina Stillwell Lscsw, LLC
- Tlec Clay Washington Infant Toddler Program
All providers in Clay Center, KS · Clinical Social Worker in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 10, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.