Healthcare Provider Details

I. General information

NPI: 1003764937
Provider Name (Legal Business Name): REFLECTIVE WATERS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7170 SAND CREST VW
COLORADO SPRINGS CO
80923-8811
US

IV. Provider business mailing address

7170 SAND CREST VW
COLORADO SPRINGS CO
80923-8811
US

V. Phone/Fax

Practice location:
  • Phone: 719-219-8437
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY WEILAND
Title or Position: ONWER
Credential: LPC
Phone: 719-319-8437