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General NPI Number Information
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NPI Number | 1528842440
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Entity Type | Organization
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Legal Business Name | THE WILLOW TREE COUNSELING, LLC
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Dates
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Enumeration Date | 08/22/2023
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 8 BLOOMINGTON LN
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City | STAFFORD
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State | VA
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Zip | 22554-7727
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Country | US
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Telephone | 540-645-8992
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Fax | 540-318-8804
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Provider Business Mailing Address
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Address Line | 2650 RICHMOND HWY UNIT 501
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City | STAFFORD
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State | VA
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Zip | 22554-5095
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Country | US
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Telephone | 540-645-8992
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Fax | 540-318-8804
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Authorized Official
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Title or Position | OWNER
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Name | ELESIA S VANBUREN
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Credential | COUNSELOR
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Telephone | 540-645-8992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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