Kathleen Willoughby

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH22482 Issued in FL

Practice address

8341 Gunn Hwy
Tampa, FL 33626-1608

Phone

(813) 951-7346

NPI assigned

Aug 14, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Collaborative Therapeutic Services, LLC

  • Clinical Social Worker
  • Tampa, FL
  • NPI 1043451958
  NPD (past)

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1295518405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3115 RESEDA CT",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336183013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8341 GUNN HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336261608",
            "telephone_number": "813-951-7346"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3115 Reseda Ct",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336183013",
            "country_code": "US",
            "telephone_number": "937-605-0302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLOUGHBY",
        "first_name": "KATHLEEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH22482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Anne Willis, MA CCC SLP
• Lorena Willis
• Wendy Willis
• Amy Lynn Willitzer, A.R.N.P.
• Martin Anthony Willmitch, D.C.
• Shelby Willoughby, DMD
• Julianna L Willow, LMT
• Willows Wellness Coaching
• Brianna Nichole Wills, PT, DPT
• Marketa M Wills, MD

• Mental Health Counselor in Tampa, FL
• Providers in Tampa, 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 Aug 14, 2023; 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.