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General NPI Number Information
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NPI Number | 1609739267
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Entity Type | Organization
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Legal Business Name | WILLOWED PATH THERAPY
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Dates
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Enumeration Date | 12/09/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 967 WATERVIEW DR
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City | CROWNSVILLE
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State | MD
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Zip | 21032-1221
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Country | US
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Telephone | 443-457-0066
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Fax |
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Provider Business Mailing Address
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Address Line | 967 WATERVIEW DR
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City | CROWNSVILLE
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State | MD
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Zip | 21032-1221
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Country | US
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Telephone | 443-457-0066
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VIRGINIA PATRICIA GREENE
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Credential | LCSW-C
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Telephone | 443-670-4392
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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