Willow Wellness Center, PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

WILLOW WELLNESS CENTER, PLLC

Practice address

2604 Dempster St Ste 401
Park Ridge, IL 60068-8428

Phone

(847) 318-8200

Fax

(224) 478-0026

NPI assigned

Aug 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Cecilia Campbell, PSY.D.NPI 1184730764

Title

Co-Director

Phone

(847) 318-8200

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 7

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

• Lisa Cecilia Campbell, PSY.D.

  • Clinical Psychologist
  • Park Ridge, IL
  • NPI 1184730764
  Medicare reassignment Care Compare group NPD Authorized official
• Meghan Rivard

  • Mental Health Counselor
  • Park Ridge, IL
  • NPI 1588385140
  Medicare reassignment Care Compare group NPD
• Mary Morag Sutherland, PSY.D.

  • Clinical Psychologist
  • Park Ridge, IL
  • NPI 1255651162
  Medicare reassignment Care Compare group NPD
• Robert Bruce Campbell, PSY.D., M.DIV.

  • Clinical Psychologist
  • Park Ridge, IL
  • NPI 1225375389
  Medicare reassignment Care Compare group
• Caren Jeskey, LCSW

  • Clinical Social Worker
  • Chicago, IL
  • NPI 1629401120
  Medicare reassignment Care Compare group
• Noel Widholm, MSW, LCSW

  • Clinical Social Worker
  • Arlington Heights, IL
  • NPI 1881088912
  Medicare reassignment Care Compare group
• Jill Ann Narcisi, PSY.D.

  • Clinical Psychologist
  • Park Ridge, IL
  • NPI 1962534461
  NPD (past)

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739318400000",
    "number": "1154437739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST STE 402",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688438",
            "telephone_number": "847-318-8200",
            "fax_number": "224-478-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2604 DEMPSTER ST STE 401",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600688428",
            "telephone_number": "847-318-8200",
            "fax_number": "224-478-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW WELLNESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2025-02-12",
        "certification_date": "2025-02-12",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "CECILIA",
        "authorized_official_title_or_position": "CO-DIRECTOR",
        "authorized_official_telephone_number": "847-318-8200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James R Williams
• Martina Williams, MD
• Sheri Yamashita Williams, AUD
• Diane M Williamson, LMT, CMCE
• Cindi-Marie Dingman Willoughby, PSY. D.
• Neil S Wilner, D.D.S.
• Kelsey Marie Winck, MSN, FNP-BC
• Tracy Ann Winger, M.D.
• Ian Walker Winter, MD
• Layla Wisser, DO

• Adult Mental Health Clinic/Center in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Adult Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.