Organization Name: | STILLWATERS COUNSELING LLC |
NPI Number: | 1063729598 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LISA L. JORDAN (CLINICAL SOCIAL WORKER) |
Mailing Address: | 316 N 10th St Worland |
State: | WY US |
Postal Code: | 824012307 |
Phone Number: | 3074311317 |
Fax Number: | |
NPI Enumeration Date: | 09/03/2010 |
NPI Last Update Date: | 09/03/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | LCSW-451 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |