Healthcare Provider Details
I. General information
NPI: 1598676348
Provider Name (Legal Business Name): BENEATH THE WILLOW THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2026
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1500 BRUSH MOUNTAIN RD
LENOIR NC
28645-7554
US
IV. Provider business mailing address
1500 BRUSH MOUNTAIN RD
LENOIR NC
28645-7554
US
V. Phone/Fax
- Phone: 828-929-5217
- Fax:
- Phone: 828-929-5217
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MEGAN
HAGAN
Title or Position: OWNER
Credential: LCSW
Phone: 828-929-5217