MEDICARE: WILLOW MENTAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1215871876
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLOW MENTAL HEALTH

Provider Business Mailing Address
First Line	:	400 WALNUT PLAIN RD
Second Line	:
City	:	ROCHESTER
State	:	MA
Zip	:	02770-4050
Country	:	US
Telephone Number	:	508-965-1309
Fax Number	:	866-437-5208

Provider Business Practice Location Address
First Line	:	74 FAUNCE CORNER RD UNIT 610
Second Line	:
City	:	DARTMOUTH
State	:	MA
Zip	:	02747-1209
Country	:	US
Telephone Number	:	508-965-1309
Fax Number	:	866-437-5208

Authorized Official
Title or Position	:	OWNER
Name	:	WANDA NUNES
Credential	:
Telephone Number	:	800-735-8951

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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Directions to “WILLOW MENTAL HEALTH ” Practice Location

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