Healthcare Provider Details

I. General information

NPI: 1619503224
Provider Name (Legal Business Name): WILLINGNESS COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2020
Last Update Date: 03/14/2020
Certification Date: 03/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5775 S SADDLE RIDGE LN
TUCSON AZ
85746-3635
US

IV. Provider business mailing address

6616 W DREXEL RD
TUCSON AZ
85757-9560
US

V. Phone/Fax

Practice location:
  • Phone: 520-784-4237
  • Fax:
Mailing address:
  • Phone: 520-784-4237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM YORK
Title or Position: CLINICIAN
Credential: LPC
Phone: 520-784-4237