Active NPI
Willow Oak Therapy Center, Inc.
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Rockville, MD
National Provider Identifier
1386620581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Legal business name
- WILLOW OAK THERAPY CENTER, INC.
- Practice address
- 15701 Crabbs Branch Way
Rockville, MD 20855-2634 - Phone
- (301) 251-8965
- Fax
- (301) 251-0136
- NPI assigned
- Dec 20, 2005
- 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
- Ms. Jody Tabner Thayer, LCSW-C
- Title
- Executive Director
- Phone
- (301) 251-8965
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 |
|---|---|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X | Primary |
Addresses
Primary practice location
15701 Crabbs Branch Way
Rockville, MD 20855-2634
Mailing address
15701 Crabbs Branch Way
Rockville, MD 20855-2634
Phone (301) 251-8965
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 125603300 | Medicaid | MD | |
| 7726 | Other | DC | BLUE CROSS BLUE SHIELD |
| 5458AF | Other | MD | BCBS |
Other names 1
- Affiliated Community Counselors, Inc.
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
15701 Crabbs Branch Way
Rockville, MD 20855
Phone (301) 251-8965
15841 Crabbs Branch Way
Rockville, MD 20855
Phone (301) 251-8965
Practitioners & affiliated clinicians
Practitioners 34
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135036800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1490918400000",
"number": "1386620581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15701 CRABBS BRANCH WAY",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208552634",
"telephone_number": "301-251-8965",
"fax_number": "301-251-0136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15701 CRABBS BRANCH WAY",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208552634",
"telephone_number": "301-251-8965",
"fax_number": "301-251-0136"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLOW OAK THERAPY CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-12-20",
"last_updated": "2017-03-31",
"status": "A",
"authorized_official_last_name": "THAYER",
"authorized_official_first_name": "JODY",
"authorized_official_middle_name": "TABNER",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "301-251-8965",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "LCSW-C"
},
"taxonomies": [
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "125603300",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "7726",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5458AF",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Affiliated Community Counselors, Inc.",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.