Provider Demographics
NPI:1710688171
Name:CALMING WATERS PSYCHIATRY LLC
Entity Type:Organization
Organization Name:CALMING WATERS PSYCHIATRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:FLORENCE
Authorized Official - Last Name:MATTINGLY
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:719-650-0438
Mailing Address - Street 1:12662 TIMBERGLEN TER
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80921-3759
Mailing Address - Country:US
Mailing Address - Phone:719-439-3072
Mailing Address - Fax:
Practice Address - Street 1:7222 COMMERCE CENTER DR STE 220
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80919-2631
Practice Address - Country:US
Practice Address - Phone:719-650-0438
Practice Address - Fax:719-418-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty