| Tina Stillwell Lscsw, Llc | |
|
1611 7th St Clay Center KS 67432-1801 | |
| (785) 630-5500 | |
| (785) 630-5500 |
| Full Name | Tina Stillwell Lscsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1611 7th St, Clay Center, Kansas |
| Authorized Official Name and Position | Tina Stillwell (OWNER) |
| Authorized Official Contact | 7856305500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tina Stillwell Lscsw, Llc 1611 7th St Clay Center KS 67432-1801 Ph: (785) 630-5500 | Tina Stillwell Lscsw, Llc 1611 7th St Clay Center KS 67432-1801 Ph: (785) 630-5500 |
| NPI Number | 1750857967 |
|---|---|
| Provider Enumeration Date | 10/16/2018 |
| Last Update Date | 10/16/2018 |
| Medicare PECOS PAC ID | 7012260219 |
|---|---|
| Medicare Enrollment ID | O20181105000894 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750857967 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tina M Stillwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609004456 PECOS PAC ID: 4385778182 Enrollment ID: I20100816000710 |
Mellies Mental Wellness Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 619 Court St, Clay Center, KS 67432 Phone: 785-630-5500 Fax: 785-630-5295 |