Willow Mark Therapy PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

WILLOW MARK THERAPY PLLC

Practice address

303 W Pearl St
Granbury, TX 76048-2451

Phone

(817) 578-6775

NPI assigned

Jan 14, 2021

Last updated

Jan 14, 2021By 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

Jennifer Caudle, LPCNPI 1982208633

Title

Therapist

Phone

(817) 578-6775

Specialties & licenses 1

Addresses

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.

• Jennifer Caudle

  • Professional Counselor
  • Granbury, TX
  • NPI 1982208633
  NPD Authorized official

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

{
    "created_epoch": "1610582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1053900928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 DART CT",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760491283",
            "telephone_number": "817-578-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W PEARL ST",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760482451",
            "telephone_number": "817-578-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW MARK THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-14",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "CAUDLE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "817-578-6775",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William R Reeves, Jr DDS PC
• Betty Michelle Williams, FNP
• Donna Karen Williams, LPC
• Tressa Fae Williams
• Jill Willis, LPC
• Catherine Cornelia Wilson, FNP-BC
• Jennifer Jo Winkle, AU.D.,CCC-A
• Winnie-Stowell Hospital District (Harbor Lakes Nursing and Rehabilitation Center)
• Brycen Witcher, MD
• Gene Wong, O.D.

• Professional Counselor in Granbury, TX
• Providers in Granbury, TX by specialty
• Professional Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.