Organization Active NPI

Still Waters Mental Health and Wellness PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • West Union, IA
National Provider Identifier
1891433496
Registry record updated Dec 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
STILL WATERS MENTAL HEALTH AND WELLNESS PLLC
Practice address
317 Hwy 150 North
West Union, IA 52175
Phone
(563) 278-2432
Fax
(563) 316-6841
NPI assigned
May 24, 2022
Last updated
Dec 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2023

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

Authorized official

Name
Nicolette Mabb, DNP, ARNP, PMHNP-BCNPI 1629487632
Title
Owner
Phone
(563) 774-2083

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

317 Hwy 150 North
West Union, IA 52175

Mailing address

PO Box 342
West Union, IA 52175-0342
Phone (563) 278-2432

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221206000713 IA Part B Supplier - Clinic/Group Practice 9234508763 Receives reassigned benefits from 1 practitioner
Practice locations: West Union, IA

National Provider Directory

National Provider Directory

Locations

117 S Vine St
West Union, IA 52175
Phone (563) 278-2432

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1653350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701734400000",
    "number": "1891433496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 342",
            "city": "WEST UNION",
            "state": "IA",
            "postal_code": "521750342",
            "telephone_number": "563-278-2432",
            "fax_number": "563-316-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 HWY 150 NORTH",
            "city": "WEST UNION",
            "state": "IA",
            "postal_code": "52175",
            "telephone_number": "563-278-2432",
            "fax_number": "563-316-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILL WATERS MENTAL HEALTH AND WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-24",
        "last_updated": "2023-12-05",
        "certification_date": "2023-12-05",
        "status": "A",
        "authorized_official_last_name": "MABB",
        "authorized_official_first_name": "NICOLETTE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-774-2083",
        "authorized_official_credential": "DNP, ARNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Union, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2023; 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.