Willow Harbor Therapy Center, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

SW12317 Issued in FL

Legal business name

WILLOW HARBOR THERAPY CENTER, LLC

Practice address

1010 N 12TH Ave Ste 321
Pensacola, FL 32501-3370

Phone

(850) 776-6297

NPI assigned

Sep 22, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Sabrina Irene Conklin, DSW, LCSW

Title

Ceo/Owner

Phone

(850) 776-6297

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1295244127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N 12TH AVE STE 321",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013370",
            "telephone_number": "850-776-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 N 12TH AVE STE 321",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013370",
            "telephone_number": "850-776-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW HARBOR THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_middle_name": "IRENE",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "850-776-6297",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSW, LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "SW12317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Van A Willis II, DO
• Wayne S Willis, MD
• William S Willis, MD
• Suzzanna V Williston
• Mary Margaret Willoughby
• Willow Tree Counseling, LLC
• Jackie Willson
• Sherian B Wilmot-Carter, APRN
• Dana Wilmot, BCBA
• Kathryn Julia Wilmot, MS, LAT, ATC

• Mental Health Counselor in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.