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General NPI Number Information
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NPI Number | 1427775741
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Entity Type | Organization
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Legal Business Name | THE WILLOW CENTER, LLC
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Dates
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Enumeration Date | 10/26/2022
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 510 W GRAND RIVER AVE STE 200
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City | BRIGHTON
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State | MI
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Zip | 48116-2386
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Country | US
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Telephone | 810-360-8920
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Fax |
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Provider Business Mailing Address
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Address Line | 2057 COBBLESTONE LN
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City | BRIGHTON
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State | MI
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Zip | 48114-7349
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Country | US
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Telephone | 810-360-8920
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | ABIGAIL MICHAELS USHER
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Credential | LMSW
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Telephone | 810-360-8920
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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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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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