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General NPI Number Information
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NPI Number | 1588478978
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Entity Type | Organization
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Legal Business Name | WILLIS COUNSELING & CONSULTING
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 1947 RICHARDS RD APT 10
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City | TOLEDO
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State | OH
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Zip | 43607-1040
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Country | US
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Telephone | 567-318-2586
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Fax |
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Provider Business Mailing Address
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Address Line | 5834 MONROE ST STE 1201
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City | SYLVANIA
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State | OH
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Zip | 43560-2267
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | KAJUAN WILLIS
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Credential | LPC
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Telephone | 240-278-9213
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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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