Healthcare Provider Details

I. General information

NPI: 1255258406
Provider Name (Legal Business Name): STILL WATERS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W SOUTH BOULDER RD
LAFAYETTE CO
80026-8951
US

IV. Provider business mailing address

1120 W SOUTH BOULDER RD
LAFAYETTE CO
80026-8951
US

V. Phone/Fax

Practice location:
  • Phone: 303-736-9819
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JACQUELINE WINKELMAN
Title or Position: SOCIAL WORKER
Credential: LCSW
Phone: 303-736-9819