Willow Creek Counseling LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

16765 Issued in MN

Legal business name

WILLOW CREEK COUNSELING LLC

Practice address

17 Ash Street
New London, MN 56273

Phone

(651) 356-2458

NPI assigned

Jul 28, 2016

Last updated

Jul 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Claudette M Larson, LICSWNPI 1306984497

Title

Owner/Partner

Phone

(651) 356-2458

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

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.

• Claudette M Larson, LICSW

  • Social Worker
  • Benson, MN
  • NPI 1306984497

  Clinical

  Medicare reassignment Care Compare group NPD Authorized official
• Kristin Ann Schmidt, LICSW

  • Mental Health Counselor
  • New London, MN
  • NPI 1801342696
  Medicare reassignment Care Compare group NPD
• Nicholas Goelz

  • Mental Health Counselor
  • New London, MN
  • NPI 1598466062
  NPD

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469664000000",
    "number": "1538612239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24050 40TH ST NE",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "562739699",
            "telephone_number": "651-356-2458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ASH STREET",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "56273",
            "telephone_number": "651-356-2458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A",
        "authorized_official_last_name": "LARSON",
        "authorized_official_first_name": "CLAUDETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "651-356-2458",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "16765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Van Beck
• Amber O Vick, MD
• Clarence William Walker, PH.D
• Richard A Wehseler, MD
• Susan Jacobs Werner, OTR/L
• Donald Michael Zieske, D.C.

• Clinical Social Worker in New London, MN
• Providers in New London, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; 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.

Verify at the official NPI Registry.