Willow Integrative Wellness

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WILLOW INTEGRATIVE WELLNESS

Practice address

216 E Ridgewood Ave Ste 3B
Ridgewood, NJ 07450-3849

Phone

(201) 637-4345

NPI assigned

Apr 22, 2025

Organization subpart

No

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

Authorized official

Name

Emily Coyle, PMHNP-BCNPI 1174158299

Title

Psychiatric Nurse Practitioner

Phone

(551) 288-6543

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 3

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

• Emily Coyle, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Ridgewood, NJ
  • NPI 1174158299
  Medicare reassignment Care Compare group NPD Authorized official
• Amanda Danielle Moroz, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Neptune, NJ
  • NPI 1043832520
  Medicare reassignment Care Compare group NPD
• Kimberly Meserole, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Ridgewood, NJ
  • NPI 1104792548
  Medicare reassignment NPD

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

{
    "created_epoch": "1745280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1225825490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 E RIDGEWOOD AVE STE 3B",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503849",
            "telephone_number": "551-288-6543",
            "fax_number": "551-212-3041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 E RIDGEWOOD AVE STE 3B",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503849",
            "telephone_number": "201-637-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW INTEGRATIVE WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-22",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "COYLE",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "551-288-6543",
        "authorized_official_credential": "PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Wieder, M.D.
• Michael I Wiener, D.O.
• Heather Wilke, LPC, LCADC
• William P Carney MD LLC
• Williambecker MD and Nina Sugar MD Child and Adolescentpsychiatry,LLC
• Robert Spencer Wilson, LCSW
• Lydia Winnicka, M.D.
• Marylynn R. Wiseman, LCSW
• Erik Wohlfarth
• Sharon McGovern Wolbert, PH.D.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.