Willow Therapy PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

WILLOW THERAPY PLLC

Practice address

509 Scott Ave Ste 2B
Woodland Park, CO 80863-1294

Phone

(719) 201-8714

NPI assigned

Jun 19, 2020

Last updated

Jun 19, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Candice Kaye Berger, LPCNPI 1124668991

Title

Owner

Phone

(719) 201-8714

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Candice Berger

  • Professional Counselor
  • Woodland Park, CO
  • NPI 1124668991
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592524800000",
    "number": "1043836687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 116",
            "city": "DIVIDE",
            "state": "CO",
            "postal_code": "808140116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 SCOTT AVE STE 2B",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808631294",
            "telephone_number": "719-201-8714"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2210 E La Salle St # 219",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809092303",
            "country_code": "US",
            "telephone_number": "719-201-8714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILLOW THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-19",
        "last_updated": "2020-06-19",
        "certification_date": "2020-06-19",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "CANDICE",
        "authorized_official_middle_name": "KAYE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-201-8714",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORA",
            "identifier": "LPC.0014523",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyce Lynn Wik
• James Russell Wiley, D.C.
• William R Schroeder DO PC
• Julie Budrzysky Williams, M.A,, CCC-SLP
• Richard Paul Willman
• Kari-Lynn NMN Wilson, MA
• Woodland Counseling Center
• Woodland Park Ambulance
• Woodland Park Anesthesia LLC
• Woodland Park Dental Professional LLC

• Professional Counselor in Woodland Park, CO
• Providers in Woodland Park, CO by specialty
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.