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General NPI Number Information
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NPI Number | 1225522279
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Entity Type | Individual
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Provider Name | SHAWNA STILLWELL IMFT MA
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Gender | Female
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 11/30/2025
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Provider Practice Location Address
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Address Line | 1554 POLARIS PKWY STE 325
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City | COLUMBUS
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State | OH
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Zip | 43240-4085
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Country | US
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Telephone | 216-307-4229
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Fax | 877-503-6591
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Provider Business Mailing Address
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Address Line | 1554 POLARIS PKWY STE 325
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City | COLUMBUS
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State | OH
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Zip | 43240-4085
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Country | US
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Telephone | 216-307-4229
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Fax | 877-503-6591
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | F.2000147
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License Number State | OH
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