Organization Active NPI

Willow Tree Clinic

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1093438491
Registry record updated May 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
WILLOW TREE CLINIC
Practice address
345 Saint Peter St Apt 1411
Saint Paul, MN 55102-3949
Phone
(320) 441-8661
NPI assigned
Sep 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2026

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

Authorized official

Name
Todd R Engle
Title
Clinic Manager
Phone
(320) 905-1445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

345 Saint Peter St Apt 1411
Saint Paul, MN 55102-3949

Mailing address

345 Saint Peter St Apt 1411
Saint Paul, MN 55102-3949
Phone (320) 905-1445

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1093438491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 SAINT PETER ST APT 1411",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023949",
            "telephone_number": "320-905-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 SAINT PETER ST APT 1411",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551023949",
            "telephone_number": "320-441-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-21",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "ENGLE",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "320-905-1445"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.