Provider Demographics
NPI:1902571664
Name:STILL WATERS COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:STILL WATERS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-975-3868
Mailing Address - Street 1:1700 NE MARKET DR
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:OR
Mailing Address - Zip Code:97024-0810
Mailing Address - Country:US
Mailing Address - Phone:458-218-8694
Mailing Address - Fax:
Practice Address - Street 1:5200 SW MEADOWS RD
Practice Address - Street 2:STE 200
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035
Practice Address - Country:US
Practice Address - Phone:458-218-8694
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Single Specialty