Organization Active NPI

Still Waters Holdings

Doing business as Still Waters Professional Counseling

  • Mental Health Counselor
  • Muncie, IN
National Provider Identifier
1730116187
Registry record updated Jan 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
STILL WATERS HOLDINGS
Doing business as
Still Waters Professional Counseling
Practice address
3301 W Purdue Ave
Muncie, IN 47304-6356
Phone
(765) 284-0043
Fax
(765) 284-4112
NPI assigned
Jun 28, 2006
Last updated
Jan 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2024

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

Authorized official

Name
Meredith BoatwrightNPI 1144779174
Title
Owner
Phone
(765) 284-0043

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 10

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary
Professional Counselor 101YP2500X
Counseling Psychologist 103TC1900X 20041894A IN
Counseling Psychologist 103TC1900X 20041851A IN
Counseling Psychologist 103TC1900X 20041828A IN
Counseling Psychologist 103TC1900X
Social Worker 104100000X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X 35001519A IN
Marriage & Family Therapist 106H00000X

Addresses

Primary practice location

3301 W Purdue Ave
Muncie, IN 47304-6356

Mailing address

3301 W Purdue Ave
Muncie, IN 47304-6356
Phone (765) 284-0043

Other identifiers 1

IdentifierTypeStateIssuer
740738000OtherINMAGELLAN HEALTH SERVICES

Other names 1

  • Still Waters Professional Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230413000493 IN Part B Supplier - Clinic/Group Practice 3476928060 Receives reassigned benefits from 14 practitioners
Practice locations: Muncie, IN

National Provider Directory

National Provider Directory

Locations

1904 W Royale Dr
Muncie, IN 47304
Phone (765) 284-0043

2700 N Wheeling Ave
Ste 7
Muncie, IN 47303
Phone (765) 281-2952

Practitioners & affiliated clinicians

Practitioners 36

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.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705190400000",
    "number": "1730116187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046356",
            "telephone_number": "765-284-0043",
            "fax_number": "765-284-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 W PURDUE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473046356",
            "telephone_number": "765-284-0043",
            "fax_number": "765-284-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILL WATERS HOLDINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2024-01-14",
        "certification_date": "2024-01-14",
        "status": "A",
        "authorized_official_last_name": "BOATWRIGHT",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "765-284-0043"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20041894A",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20041851A",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "IN",
            "license": "20041828A",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IN",
            "license": "35001519A",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH SERVICES",
            "identifier": "740738000",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Still Waters Professional Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Muncie, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.