NPIMap

Organization Active NPI

Willow Tree Occupational Therapy, LLC

  • Pediatric Occupational Therapist
  • Corinth, ME
National Provider Identifier
1366098477
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
Legal business name
WILLOW TREE OCCUPATIONAL THERAPY, LLC
Practice address
64 Exeter Rd
Corinth, ME 04427-3050
Phone
(207) 659-1453
NPI assigned
Aug 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Authorized official

Name
Laura Baker Goulet, OTR/LNPI 1154517969
Title
Occupational Therapist
Phone
(207) 659-1453

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)CodeLicenseStatePrimary
Pediatric Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225XP0200X Primary

Addresses

Primary practice location

64 Exeter Rd
Corinth, ME 04427-3050

Mailing address

64 Exeter Rd
Corinth, ME 04427-3050
Phone (207) 659-1453

Other identifiers 1

IdentifierTypeStateIssuer
1154517969MedicaidME

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address laura@willowtreeot.com

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565740800000",
    "number": "1366098477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 EXETER RD",
            "city": "CORINTH",
            "state": "ME",
            "postal_code": "044273050",
            "telephone_number": "207-659-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 EXETER RD",
            "city": "CORINTH",
            "state": "ME",
            "postal_code": "044273050",
            "telephone_number": "207-659-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE OCCUPATIONAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-08-14",
        "status": "A",
        "authorized_official_last_name": "BAKER GOULET",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "207-659-1453",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154517969",
            "state": "ME"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laura@willowtreeot.com",
            "affiliation": "N",
            "address_1": "64 Exeter Rd",
            "city": "Corinth",
            "state": "ME",
            "country_code": "US",
            "postal_code": "044273050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Corinth, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.