Healthcare Provider Details
I. General information
NPI: 1114857117
Provider Name (Legal Business Name): WILLOWBROOK PSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5135 GREYSTONE CT
HARBOR SPGS MI
49740-8745
US
IV. Provider business mailing address
2501 CHATHAM RD STE N
SPRINGFIELD IL
62704-4188
US
V. Phone/Fax
- Phone: 224-875-0595
- Fax:
- Phone: 872-221-0797
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
BROOKE
STENGLEIN
Title or Position: OWNER
Credential: PSY.D.
Phone: 224-875-0595