Healthcare Provider Details

I. General information

NPI: 1639089972
Provider Name (Legal Business Name): STILL WATERS WELLNESS AND HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5373 N UNION BLVD STE 200
COLORADO SPRINGS CO
80918-2053
US

IV. Provider business mailing address

450 OXBOW DR
MONUMENT CO
80132-6026
US

V. Phone/Fax

Practice location:
  • Phone: 719-232-4014
  • Fax:
Mailing address:
  • Phone: 719-232-4014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANDREA SPENCER
Title or Position: OWNER
Credential: MS, LPC, ACS, MFTC
Phone: 719-232-4014