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General NPI Number Information
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NPI Number | 1518476878
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Entity Type | Organization
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Legal Business Name | WILLOW PATH COLLECTIVE, PLLC
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Dates
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Enumeration Date | 09/29/2017
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 10603 CARMONA
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City | HELOTES
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State | TX
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Zip | 78023-4691
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Country | US
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Telephone | 726-224-7428
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Fax | 210-634-2312
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Provider Business Mailing Address
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Address Line | PO BOX 848
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City | HELOTES
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State | TX
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Zip | 78023-0848
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Country | US
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Telephone | 210-846-4935
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ESMERALDA G CARDENAS
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Credential | LPC
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Telephone | 210-846-4935
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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 | 71039
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License Number State | TX
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