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General NPI Number Information
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NPI Number | 1063279503
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Entity Type | Organization
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Legal Business Name | STILL WATERS MENTAL HEALTH, LLC
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Dates
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Enumeration Date | 03/01/2024
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Last Update Date | 02/15/2026
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Provider Practice Location Address
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Address Line | 9220 TEDDY LN STE 2000D
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City | LONE TREE
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State | CO
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Zip | 80124-6740
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Country | US
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Telephone | 720-263-2528
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Fax | 866-214-1683
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Provider Business Mailing Address
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Address Line | 6553 HIGHBLUFF WAY
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City | LANCASTER
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State | CA
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Zip | 93536-1276
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SAMANTHA HUDGINS
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Credential | PA-C
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Telephone | 303-501-4194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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