Tina Stillwell Lscsw, LLC
Organization Active NPI Clinical Social Worker · Clay Center, KS
NPI 1750857967 · NPPES record last updated Oct 16, 2018
Key facts
- NPI
- 1750857967
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- Legal business name
- TINA STILLWELL LSCSW, LLC
- Practice address
- 1611 7TH St
Clay Center, KS 67432-1801 - Phone
- (785) 630-5500
- Fax
- (785) 630-5500
- NPI assigned
- Oct 16, 2018
- Organization subpart
- No
Authorized official
- Name
- Tina Stillwell, LSCSW
- Title
- Owner
- Phone
- (785) 630-5500
Practitioners 2
-
Tina Stillwell, LSCSW
-
Erin Nichole Mellies, LCPC, LCAC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20181105000894 | KS | Part B Supplier - Clinic/Group Practice | 7012260219 |
Receives reassigned benefits from 1 practitioner Practice locations: Clay Center, KS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | Yes |
Addresses
Primary practice location
1611 7TH St
Clay Center, KS 67432-1801
Mailing address
1611 7TH St
Clay Center, KS 67432-1801
Phone (785) 630-5500
Other providers in Clay Center, KS
- Laura Sue Squires
- Tina Stillwell
- Jaacob Leigh Struffert
- Kayla Sulanka
- Susan D. Thompson
- Tlec Clay Washington Infant Toddler Program
- Usd 379 Clay Center
- Kendell Dwayne Varner
- Audra Walter
- Weimer Drug Co Inc
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 Oct 16, 2018. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.