Healthcare Provider Details

I. General information

NPI: 1588321772
Provider Name (Legal Business Name): EQUILIBRIUM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2021
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 OXFORD LN
FORT COLLINS CO
80525-2261
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 Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA VONIE STILLSON
Title or Position: PRESIDENT
Credential: LPC
Phone: 970-599-1314