Healthcare Provider Details

I. General information

NPI: 1558272971
Provider Name (Legal Business Name): WILLOW & WILDFLOWER COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8400 E CRESCENT PKWY STE 609
GREENWOOD VILLAGE CO
80111-2831
US

IV. Provider business mailing address

8400 E CRESCENT PKWY STE 609
GREENWOOD VILLAGE CO
80111-2831
US

V. Phone/Fax

Practice location:
  • Phone: 720-295-9258
  • Fax:
Mailing address:
  • Phone: 720-295-9258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KELLI JOHNSON
Title or Position: OWNER
Credential: LCSW, PMH-C
Phone: 303-829-9903