Provider Demographics
NPI:1194440958
Name:WILLOW FOUNDATION
Entity type:Organization
Organization Name:WILLOW FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HELCOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:570-947-1338
Mailing Address - Street 1:287 W BUTLER DR
Mailing Address - Street 2:
Mailing Address - City:DRUMS
Mailing Address - State:PA
Mailing Address - Zip Code:18222-2314
Mailing Address - Country:US
Mailing Address - Phone:570-550-4485
Mailing Address - Fax:
Practice Address - Street 1:100 S WYOMING ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201-7055
Practice Address - Country:US
Practice Address - Phone:570-455-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty