Willow Tree Wellness, Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

WILLOW TREE WELLNESS, INC

Doing business as

Amanda Pikala

Practice address

4423 Viking Blvd NE
East Bethel, MN 55092-9494

Phone

(651) 216-5309

NPI assigned

Jul 21, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Amanda L Pikala, LMFTNPI 1366977886

Title

Owner

Phone

(651) 216-5309

Specialties & licenses 1

Addresses

Other names 1

• Amanda Pikala Doing business as

Practitioners 1

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

• Amanda Lucy Pikala, LMFT

  • Marriage & Family Therapist
  • Blaine, MN
  • NPI 1366977886
  NPD Authorized official

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1245848696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4423 VIKING BLVD NE",
            "city": "EAST BETHEL",
            "state": "MN",
            "postal_code": "550929494",
            "telephone_number": "651-216-5309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4423 VIKING BLVD NE",
            "city": "EAST BETHEL",
            "state": "MN",
            "postal_code": "550929494",
            "telephone_number": "651-216-5309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE WELLNESS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-21",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "PIKALA",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-216-5309",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amanda Pikala",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chad Peterson
• Roxanne L Peterson, RN
• Star of the North Academy
• Waage Construction Incorporated
• Trevor Weidt

• Marriage & Family Therapist in East Bethel, MN
• Providers in East Bethel, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.