NPIMap

Organization Active NPI

Willow Tree Counseling, PLLC

  • Community/Behavioral Health Agency
  • West Fargo, ND
National Provider Identifier
1497293799
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
699-10-1-11-238 Issued in ND
Legal business name
WILLOW TREE COUNSELING, PLLC
Doing business as
Willow Tree Counseling
Practice address
102 W Beaton Dr Ste 103
West Fargo, ND 58078-2653
Phone
(701) 730-8313
Fax
(701) 552-7975
NPI assigned
Feb 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Authorized official

Name
Erin Marie GrahnNPI 1669751962
Title
Owner
Phone
(701) 730-8313

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Community/Behavioral Health Agency 251S00000X 699-10-1-11-238 ND Primary
Community/Behavioral Health Agency 251S00000X 1650 ND
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

102 W Beaton Dr Ste 103
West Fargo, ND 58078-2653

Mailing address

102 W Beaton Dr Ste 103
West Fargo, ND 58078-2653
Phone (701) 730-8313

Other names 1

  • Willow Tree Counseling Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1497293799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 W BEATON DR STE 103",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782653",
            "telephone_number": "701-730-8313",
            "fax_number": "701-552-7975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 W BEATON DR STE 103",
            "city": "WEST FARGO",
            "state": "ND",
            "postal_code": "580782653",
            "telephone_number": "701-730-8313",
            "fax_number": "701-552-7975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "GRAHN",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-730-8313"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ND",
            "license": "699-10-1-11-238",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ND",
            "license": "1650",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Tree Counseling",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Willow Tree Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.