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General NPI Number Information
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NPI Number | 1942193875
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Entity Type | Organization
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Legal Business Name | WILLOWSAGE COUNSELING
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 8225 ALLEN RD STE 1103
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City | ALLEN PARK
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State | MI
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Zip | 48101-1401
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Country | US
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Telephone | 951-588-4187
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Fax | 833-635-9446
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Provider Business Mailing Address
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Address Line | 15549 REGINA AVE
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City | ALLEN PARK
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State | MI
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Zip | 48101-1904
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Country | US
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Telephone | 951-710-7980
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Fax | 833-635-9446
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | CHRISTINA BAISDEN
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Credential |
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Telephone | 951-710-7980
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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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