MEDICARE: STILLWATERS ASSESSMENT & NEUROPSYCHOLOGICAL SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1356213581
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STILLWATERS ASSESSMENT & NEUROPSYCHOLOGICAL SERVICES

Provider Business Mailing Address
First Line	:	7901 4TH ST N # 19623
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-4305
Country	:	US
Telephone Number	:	727-233-5653
Fax Number	:	844-820-0984

Provider Business Practice Location Address
First Line	:	110 ATHENS ST STE D
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34689-3304
Country	:	US
Telephone Number	:	727-233-5653
Fax Number	:	844-820-0984

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANIE BAYNES
Credential	:	PSYD
Telephone Number	:	727-233-5653

Provider Enumeration Date	:	09/18/2025
Last Update Date	:	02/18/2026

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