Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Simon J Stillwaggon

Individual provider Mental Health Counselor · NPI 1710382486

Simon J Stillwaggon is a Mental Health Counselor in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2014.

Licensed in
PA
In the registry since
2014
Specialties on file
2

Practice location Address checks out

3821 Baring St
Philadelphia, PA 19104-5580
Phone: (609) 489-2074
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MSG015461 (PA)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1710382486
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 23, 2014
Last updated in NPPESApril 29, 2026
Certification dateApril 29, 2026

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