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General NPI Number Information
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NPI Number | 1992688139
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Entity Type | Organization
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Legal Business Name | QUIET WILLOW, PLLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 309 WHEAT FIELD DR
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-8803
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Country | US
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Telephone | 330-635-4940
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Fax |
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Provider Business Mailing Address
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Address Line | 309 WHEAT FIELD DR
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City | MOUNT HOLLY
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State | NC
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Zip | 28120-8803
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Country | US
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Telephone | 440-382-7115
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Fax |
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Authorized Official
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Title or Position | COUNSELOR
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Name | MICHELLE HARTIS
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Credential | LCSW
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Telephone | 330-635-4940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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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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