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General NPI Number Information
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NPI Number | 1003752890
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Entity Type | Organization
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Legal Business Name | WILLOW BAY COUNSELING
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Dates
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Enumeration Date | 04/25/2026
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Last Update Date | 04/25/2026
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Provider Practice Location Address
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Address Line | 6450 1ST AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33710-8402
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Country | US
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Telephone | 419-345-3326
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 CROMLY CT
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City | MAUMEE
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State | OH
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Zip | 43537-4313
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Country | US
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Telephone | 419-345-3326
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERIN WILEY
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Credential | LMHC
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Telephone | 419-345-3326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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