Provider Demographics
NPI:1386505055
Name:WINDING WILLOW PSYCHOTHERAPY PLLC
Entity type:Organization
Organization Name:WINDING WILLOW PSYCHOTHERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JASPER
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:WAITE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:970-443-9809
Mailing Address - Street 1:2731 GLENDEVEY DR
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-2922
Mailing Address - Country:US
Mailing Address - Phone:970-829-8874
Mailing Address - Fax:
Practice Address - Street 1:2731 GLENDEVEY DR
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538-2922
Practice Address - Country:US
Practice Address - Phone:970-829-8874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-20
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty