Organization Name: | STILLWATERS COUNSELING, LLC |
NPI Number: | 1265846000 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KATHERINE IRENE FRECHETTE (OWNER/MANAGER) |
Mailing Address: | 425 East Hollywood Boulevard Building C, Suite #c5 Mary Esther |
State: | FL US |
Postal Code: | 32569 |
Phone Number: | 8503013525 |
Fax Number: | 8503013525 |
NPI Enumeration Date: | 06/19/2014 |
NPI Last Update Date: | 06/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH4823 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |