Healthcare Provider Details

I. General information

NPI: 1306760145
Provider Name (Legal Business Name): EQUILIBRIUM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 W OAK ST STE 290C
FORT COLLINS CO
80524-7165
US

IV. Provider business mailing address

330 N LINCOLN AVE STE 108
LOVELAND CO
80537-5600
US

V. Phone/Fax

Practice location:
  • Phone: 970-599-1314
  • Fax:
Mailing address:
  • Phone: 970-599-1314
  • 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: CHRISTINA VONIE STILLSON
Title or Position: CLINICAL DIRECTOR
Credential:
Phone: 970-599-1314