MEDICARE: A WILLOW BENDS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1134088875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A WILLOW BENDS, LLC

Provider Business Mailing Address
First Line	:	620 S CASCADE AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-4039
Country	:	US
Telephone Number	:	719-650-8114
Fax Number	:	719-686-6743

Provider Business Practice Location Address
First Line	:	620 S CASCADE AVE
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-4039
Country	:	US
Telephone Number	:	719-650-8114
Fax Number	:	719-686-6743

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	SCHEILA FARNSWORTH WATSON
Credential	:	MA, LPC, LAC
Telephone Number	:	719-650-8114

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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