| Still Water Individual And Family Therapy Services, Inc. | |
|
183 E Mcclain Ave Scottsburg IN 47170-1845 | |
| (812) 414-2331 | |
| Not Available |
| Full Name | Still Water Individual And Family Therapy Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 183 E Mcclain Ave, Scottsburg, Indiana |
| Authorized Official Name and Position | Joan Terry (DIRECTOR OF CLINICAL SERVICES) |
| Authorized Official Contact | 8124142331 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Still Water Individual And Family Therapy Services, Inc. 183 E Mcclain Ave Scottsburg IN 47170-1845 Ph: (812) 414-2331 | Still Water Individual And Family Therapy Services, Inc. 183 E Mcclain Ave Scottsburg IN 47170-1845 Ph: (812) 414-2331 |
| NPI Number | 1417593997 |
|---|---|
| Provider Enumeration Date | 11/20/2019 |
| Last Update Date | 11/20/2019 |
| Medicare PECOS PAC ID | 0042645277 |
|---|---|
| Medicare Enrollment ID | O20200116002125 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417593997 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Joan E Terry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467976266 PECOS PAC ID: 1355699083 Enrollment ID: I20180813000358 |
| Provider Name | Carissa A Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972095230 PECOS PAC ID: 2062753742 Enrollment ID: I20190405001240 |
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