| Organization Name: | STILLWATER GROUP INC |
| NPI Number: | 1154746170 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | VIRGINIA C GREEN (CEO) |
| Mailing Address: | 2100 N Sepulveda Blvd Suite 30 Manhattan Beach |
| State: | CA US |
| Postal Code: | 902662948 |
| Phone Number: | 3103782520 |
| Fax Number: | |
| NPI Enumeration Date: | 02/27/2014 |
| NPI Last Update Date: | 02/27/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MFT35443 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |