NPIMap

Organization Active NPI

Still Waters Counseling

  • Clinic/Center
  • Blackfoot, ID
National Provider Identifier
1851610760
Registry record updated May 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
LCSW261187 Issued in ID
Legal business name
STILL WATERS COUNSELING
Practice address
1309 Camas St
Blackfoot, ID 83221-3060
Phone
(208) 782-0675
Fax
(208) 782-0678
NPI assigned
May 18, 2010
Last updated
May 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2010

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

Authorized official

Name
Mrs. Stacie Lee Stephenson
Title
Office Manager
Phone
(208) 782-0675

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X LCSW261187 ID Primary

Addresses

Primary practice location

1309 Camas St
Blackfoot, ID 83221-3060

Mailing address

PO Box 903
Blackfoot, ID 83221-0903
Phone (208) 782-0675

Other identifiers 1

IdentifierTypeStateIssuer
8084327MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
Stillwaters Counseling LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1274140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274140800000",
    "number": "1851610760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 903",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832210903",
            "telephone_number": "208-782-0675",
            "fax_number": "208-782-0678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1309 CAMAS ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832213060",
            "telephone_number": "208-782-0675",
            "fax_number": "208-782-0678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILL WATERS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-18",
        "last_updated": "2010-05-18",
        "status": "A",
        "authorized_official_last_name": "STEPHENSON",
        "authorized_official_first_name": "STACIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "208-782-0675",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "ID",
            "license": "LCSW261187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8084327",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackfoot, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2010; 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.