MEDICARE: WILLOW BRANCH COUNSELING

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1811842180
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLOW BRANCH COUNSELING

Provider Business Mailing Address
First Line	:	867 J ST
Second Line	:
City	:	LINCOLN
State	:	CA
Zip	:	95648-1756
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5006 SUNRISE BLVD STE 104
Second Line	:
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-4940
Country	:	US
Telephone Number	:	916-495-5910
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	NADEZHDA TYUTYUNIK
Credential	:
Telephone Number	:	916-420-4166

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	07/01/2026

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Directions to “WILLOW BRANCH COUNSELING ” Practice Location

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