Willow Tree Healing Center LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WILLOW TREE HEALING CENTER LLC

Practice address

1516 Newmoore Dr
Gloucester, VA 23061

Phone

(252) 619-0887

NPI assigned

Mar 24, 2021

Organization subpart

No

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

Authorized official

Name

Mary Willoughby Prentiss, LPCNPI 1710587795

Title

Owner

Phone

(252) 619-0887

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Mary Willoughby Prentiss, LPC

  • Professional Counselor
  • Gloucester, VA
  • NPI 1710587795
  NPD Authorized official

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1144807553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6699 FOX CENTRE PKWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230616134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 NEWMOORE DR",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "23061",
            "telephone_number": "252-619-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE HEALING CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-24",
        "last_updated": "2023-11-08",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "PRENTISS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "WILLOUGHBY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "252-619-0887",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• April Corrin Williams, AGPCNP-BC, NP-C
• Lindsey Williams, DO
• Serena M Williams, FNP-C
• Lourdes Felisa Willoughby, BA, QMHP, SF
• Rodney Levi Willoughby, BA-CSAC-QMHP
• Deborah Wilson, ANP-BC
• Pamela Lewis Winder, OTR
• Amanda Wingfield, NP
• Pamela A. Witthaus, OTR/L, CHT
• Womens Health and Wellness LLC

• All providers in Gloucester, VA
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.