Provider Demographics
NPI:1982364980
Name:STILWELL, ANNALISE RAE (MSW)
Entity type:Individual
Prefix:
First Name:ANNALISE
Middle Name:RAE
Last Name:STILWELL
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 SHORT ST.
Mailing Address - Street 2:SUITE 5
Mailing Address - City:POUNDING MILL
Mailing Address - State:VA
Mailing Address - Zip Code:24637
Mailing Address - Country:US
Mailing Address - Phone:276-345-4304
Mailing Address - Fax:276-345-4274
Practice Address - Street 1:113 SHORT ST.
Practice Address - Street 2:SUITE 5
Practice Address - City:POUNDING MILL
Practice Address - State:VA
Practice Address - Zip Code:24637
Practice Address - Country:US
Practice Address - Phone:276-345-4304
Practice Address - Fax:276-345-4274
Is Sole Proprietor?:No
Enumeration Date:2021-12-19
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health