Healthcare Provider Details

I. General information

NPI: 1730835869
Provider Name (Legal Business Name): WILLOW COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 21ST AVE S STE 440
NASHVILLE TN
37212-5652
US

IV. Provider business mailing address

2505 21ST AVE S STE 440
NASHVILLE TN
37212-5652
US

V. Phone/Fax

Practice location:
  • Phone: 615-235-3508
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: KACEY HOLLEY
Title or Position: STAFF THERAPIST
Credential: LPC-MHSP
Phone: 903-241-4700