Healthcare Provider Details

I. General information

NPI: 1669392346
Provider Name (Legal Business Name): STILL WATERS COUNSELING AND THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 E FRIERSON AVE
TAMPA FL
33610-4951
US

IV. Provider business mailing address

801 W BAY DR STE 303
LARGO FL
33770-3223
US

V. Phone/Fax

Practice location:
  • Phone: 813-445-3689
  • Fax:
Mailing address:
  • Phone: 813-445-3689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN AGUILAR
Title or Position: LMHC/OWNER
Credential: LMHC
Phone: 813-445-3689