Provider Demographics
NPI:1699104414
Name:WILLOW TREE COUNSELING SERVICES, INC.
Entity type:Organization
Organization Name:WILLOW TREE COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, NCC
Authorized Official - Phone:248-872-2199
Mailing Address - Street 1:4920 CASS ELIZABETH RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48327-3217
Mailing Address - Country:US
Mailing Address - Phone:248-972-7291
Mailing Address - Fax:
Practice Address - Street 1:4920 CASS ELIZABETH RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48327-3217
Practice Address - Country:US
Practice Address - Phone:248-972-7291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012334251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health