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General NPI Number Information
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NPI Number | 1134084494
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Entity Type | Organization
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Legal Business Name | STILL ANCHOR MENTAL WELLNESS
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 111 2ND AVE NE
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City | ST PETERSBURG
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State | FL
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Zip | 33701-3434
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Country | US
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Telephone | 941-285-2702
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Fax |
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Provider Business Mailing Address
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Address Line | 111 2ND AVE NE
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City | ST PETERSBURG
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State | FL
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Zip | 33701-3434
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Country | US
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Telephone | 941-285-2702
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | LISA JORDAN SMOTHERMAN
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Credential | APRN
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Telephone | 941-285-2702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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