Healthcare Provider Details

I. General information

NPI: 1265223622
Provider Name (Legal Business Name): LIVING WATER TRAUMA COUNSELING AND CONSULTING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3361 N ACADEMY BLVD
COLORADO SPRINGS CO
80917-5103
US

IV. Provider business mailing address

3361 N ACADEMY BLVD
COLORADO SPRINGS CO
80917-5103
US

V. Phone/Fax

Practice location:
  • Phone: 719-204-4841
  • Fax: 719-409-0482
Mailing address:
  • Phone: 719-314-7767
  • Fax: 719-409-0482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH MOFFITT
Title or Position: OWNER/ LPC
Credential: MA, LPC, NCC, EMDR
Phone: 719-285-7466