Healthcare Provider Details

I. General information

NPI: 1962341214
Provider Name (Legal Business Name): STILL WATERS RECOVERY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 E 5TH ST
SPENCER IA
51301-5028
US

IV. Provider business mailing address

911 E 5TH ST
SPENCER IA
51301-5028
US

V. Phone/Fax

Practice location:
  • Phone: 712-363-2722
  • Fax:
Mailing address:
  • Phone: 712-363-2722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: JESSICA AMENDT
Title or Position: CO-FOUNDER & CEO / COUNSELOR
Credential: MS, IADC
Phone: 712-363-2722