Active NPI
Mindful Willow Wellness PLLC
- Clinical Social Worker
- Raleigh, NC
National Provider Identifier
1265396642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- Legal business name
- MINDFUL WILLOW WELLNESS PLLC
- Practice address
- 205 W Millbrook Rd Ste 205
Raleigh, NC 27609-4492 - Phone
- (919) 699-5450
- NPI assigned
- Dec 10, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Eliza Russ, LCSW, CEDS-C
- Title
- Owner/Therapist
- Phone
- (919) 699-5450
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | Primary |
Addresses
Primary practice location
205 W Millbrook Rd Ste 205
Raleigh, NC 27609-4492
Mailing address
2416 Treen St
Raleigh, NC 27614-7430
Phone (919) 699-5450
Other practice location 1
2416 Treen St
Raleigh, NC 27614-7430
Phone (919) 699-5450
National Provider Directory
National Provider DirectoryLocations
205 W Millbrook Rd
Ste 205
Raleigh, NC 27609
Phone (919) 699-5450
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765324800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1771632000000",
"number": "1265396642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2416 TREEN ST",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276147430",
"telephone_number": "919-699-5450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 W MILLBROOK RD STE 205",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276094492",
"telephone_number": "919-699-5450"
}
],
"practiceLocations": [
{
"address_1": "2416 Treen St",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276147430",
"country_code": "US",
"telephone_number": "919-699-5450",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "MINDFUL WILLOW WELLNESS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-12-10",
"last_updated": "2026-02-21",
"certification_date": "2026-02-21",
"status": "A",
"authorized_official_last_name": "RUSS",
"authorized_official_first_name": "ELIZA",
"authorized_official_title_or_position": "OWNER/THERAPIST",
"authorized_official_telephone_number": "919-699-5450",
"authorized_official_credential": "LCSW, CEDS-C"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.