Healthcare Provider Details

I. General information

NPI: 1144147521
Provider Name (Legal Business Name): WILLOW CREEK COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 BURT BLVD STE B
BENTON LA
71006-4904
US

IV. Provider business mailing address

185 BURT BLVD STE B
BENTON LA
71006-4904
US

V. Phone/Fax

Practice location:
  • Phone: 318-936-0511
  • Fax:
Mailing address:
  • Phone: 318-936-0511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CRYSTAL THOMPSON
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 318-990-2700