Provider Demographics
NPI:1528842440
Name:THE WILLOW TREE COUNSELING, LLC
Entity type:Organization
Organization Name:THE WILLOW TREE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELESIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:VANBUREN
Authorized Official - Suffix:
Authorized Official - Credentials:COUNSELOR
Authorized Official - Phone:540-645-8992
Mailing Address - Street 1:2650 RICHMOND HWY UNIT 501
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-5095
Mailing Address - Country:US
Mailing Address - Phone:540-645-8992
Mailing Address - Fax:540-318-8804
Practice Address - Street 1:8 BLOOMINGTON LN
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7727
Practice Address - Country:US
Practice Address - Phone:540-645-8992
Practice Address - Fax:540-318-8804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care