Provider Demographics
NPI:1588321772
Name:EQUILIBRIUM, LLC
Entity type:Organization
Organization Name:EQUILIBRIUM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:VONIE
Authorized Official - Last Name:STILLSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-599-1314
Mailing Address - Street 1:330 N. LINCLON AVE.
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-5600
Mailing Address - Country:US
Mailing Address - Phone:970-599-1314
Mailing Address - Fax:
Practice Address - Street 1:914 S. COLLEGE AVE.
Practice Address - Street 2:
Practice Address - City:FT. COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3303
Practice Address - Country:US
Practice Address - Phone:970-599-1314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EQUILIBRIUM, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty