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General NPI Number Information
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NPI Number | 1043830334
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Entity Type | Organization
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Legal Business Name | WILLOWS COUNSELING AND EMDR CENTER
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Dates
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Enumeration Date | 04/16/2020
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 20 S MAIN ST STE 21
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City | JANESVILLE
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State | WI
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Zip | 53545-3959
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Country | US
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Telephone | 608-851-0348
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Fax | 815-737-8115
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Provider Business Mailing Address
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Address Line | 20759 BURR OAK RD
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City | CAPRON
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State | IL
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Zip | 61012-9616
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Country | US
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Telephone | 815-482-2563
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Fax | 815-737-8115
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Authorized Official
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Title or Position | OWNER
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Name | MARY COLLINS
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Credential | LPC-IT, CSAC
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Telephone | 608-851-0348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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