John R Stillman is a Clinical in Minneapolis, Minnesota. John R Stillman practices all healthcare services and medical treatments related to Clinical. The NPI Number for John R Stillman is 1710920608. The last update date is 2008-08-28.
John R Stillman's current location address is 2809 Wayzata Blvd, Minneapolis, Minnesota. You can contact this provider via phone number 6123779190 and fax number 6123744498. The mailing address for John R Stillman is 2809 Wayzata Blvd, Minneapolis, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John R Stillman |
|---|---|
| Address | 2809 Wayzata Blvd, Minneapolis, Minnesota |
| Phone Number | 6123779190 |
| Fax Number | 6123744498 |
| Sole Proprietor | N |
| Credentials | LICSW |
NPI Number Detail
| NPI Number | 1710920608 |
|---|---|
| Provider Enumeration Date | 2006-06-14 |
| Last Updated Date | 2008-08-28 |
Provider Mailing Address Detail
| Address | 2809 Wayzata Blvd |
|---|---|
| City | Minneapolis |
| State | Minnesota (MN) |
| Post Code | 554052131 |
| Phone Number | 6123779190 |
| Fax Number | 6123744498 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 12770 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 467821400 | MN | -- |
Post Comment/ Review Below
What is the unique identifier code issued to John R Stillman by the Centers for Medicare & Medicaid Services (CMS)?
The John R Stillman has been assigned the NPI (National Provider Identifier) 1710920608. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where John R Stillman is located?
The John R Stillman is situated at the following address: 2809 Wayzata Blvd, Minneapolis, MN, 554052131.
What is the John R Stillman's specialty and taxonomy code?
The John R Stillman's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
On what date was the 1710920608 assigned to John R Stillman?
The John R Stillman was issued its 1710920608 on 2006-06-14, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the John R Stillman's details last updated?
The information pertaining to the John R Stillman, including its address, specialty, and other details, was most recently updated on 2008-08-28.