Healthcare Provider Details

I. General information

NPI: 1922964451
Provider Name (Legal Business Name): WILLOW BRANCHES OF HEALING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3602 HOLMES RD
CAMBRIDGE OH
43725-8988
US

IV. Provider business mailing address

5095 LOWER BLOOMFIELD RD
NEW CONCORD OH
43762-9695
US

V. Phone/Fax

Practice location:
  • Phone: 740-630-1236
  • Fax:
Mailing address:
  • Phone: 740-630-1236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: JILLIAN ARENA
Title or Position: OWNER
Credential:
Phone: 740-630-1236