=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356213581
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STILLWATERS ASSESSMENT & NEUROPSYCHOLOGICAL SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2025
-----------------------------------------------------
Last Update Date | 02/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 110 ATHENS ST STE D
-----------------------------------------------------
City | TARPON SPRINGS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34689-3304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-233-5653
-----------------------------------------------------
Fax | 844-820-0984
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7901 4TH ST N # 19623
-----------------------------------------------------
City | ST PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33702-4305
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-233-5653
-----------------------------------------------------
Fax | 844-820-0984
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | STEPHANIE BAYNES
-----------------------------------------------------
Credential | PSYD
-----------------------------------------------------
Telephone | 727-233-5653
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------