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Organization

STILLWATER COUNSELING ASSOCIATES, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KAREN D CHARLES MSW, LCSW (CLINICIAN)
(480) 251-2156
Entity
Organization

Contact information

Practice address
935 E MAIN ST, SUITE 101, MESA, AZ 85203-8874
(480) 615-5921
(480) 615-5921
Mailing address
935 E MAIN ST, SUITE 101, MESA, AZ 85203-8874
(480) 615-5921
(480) 615-5921

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCSW-10704
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1407086754
NPI TYPE 1
AZ
Enumeration date
08/10/2010
Last updated
08/10/2010
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