NPIMap

Organization Active NPI

Willow Tree Couneling and Eduational Center, LLC

  • Mental Health Counselor
  • Fairfax, VA
National Provider Identifier
1215357611
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0701004932 Issued in VA
Legal business name
WILLOW TREE COUNELING AND EDUATIONAL CENTER, LLC
Practice address
10195 Main St
Suite N
Fairfax, VA 22031-3415
Phone
(703) 591-9600
Fax
(703) 591-9656
NPI assigned
Apr 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Authorized official

Name
Marsha Evans, LPC
Title
Licensed Profesional Counselor
Phone
(703) 591-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 0701004932 VA Primary

Addresses

Primary practice location

10195 Main St
Suite N
Fairfax, VA 22031-3415

Mailing address

10195 Main St
Suite N
Fairfax, VA 22031-3415

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398297600000",
    "number": "1215357611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10195 MAIN ST",
            "address_2": "SUITE N",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10195 MAIN ST",
            "address_2": "SUITE N",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220313415",
            "telephone_number": "703-591-9600",
            "fax_number": "703-591-9656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE COUNELING AND EDUATIONAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2014-04-24",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "LICENSED PROFESIONAL COUNSELOR",
        "authorized_official_telephone_number": "703-591-9600",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701004932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2014; 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.