Weeping Willow Therapy Group LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WEEPING WILLOW THERAPY GROUP LLC

Practice address

1970 Main St E Ste B53
Snellville, GA 30078-6463

Phone

(404) 513-8839

NPI assigned

Dec 20, 2022

Organization subpart

No

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

Authorized official

Name

Brandon Davis

Title

Administrator

Phone

(404) 513-8839

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1671494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1376255448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 MAIN ST E STE B53",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 MAIN ST E STE B53",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786463",
            "telephone_number": "404-513-8839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEEPING WILLOW THERAPY GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-20",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "404-513-8839"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.