Willow Collective

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WILLOW COLLECTIVE

Practice address

706 S College Ave Ste 204
Fort Collins, CO 80524-9860

Phone

(970) 581-5155

NPI assigned

Oct 19, 2021

Organization subpart

No

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

Authorized official

Name

Mary Elizabeth Swanson, LCSW

Title

Manager/Member

Phone

(970) 581-5155

Specialties & licenses 1

Addresses

Tax ID family

Willow Collective2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Willow Collective

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Collins, CO
  • NPI 1033874995
  NPD tax ID

Locations

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1700549557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 S COLLEGE AVE STE 204",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805249860",
            "telephone_number": "970-581-5155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 S COLLEGE AVE STE 204",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805249860",
            "telephone_number": "970-581-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "149 W Oak St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Fort Collins",
            "state": "CO",
            "postal_code": "805247110",
            "country_code": "US",
            "telephone_number": "970-829-0992",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WILLOW COLLECTIVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "MANAGER/MEMBER",
        "authorized_official_telephone_number": "970-581-5155",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jon R Willison, DDS
• Erin K. Willits, MD
• Ronda Loreen Willmot, AU.D., CCC-A
• Brant Michael Willoughby, C.O.T.A.
• Willow Collective
• Willow Collective Foundation
• Willow Roots Therapy PLLC
• Willow Tree Studios, LLC
• Devin Wills
• Nicole Wilshusen, MT-BC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.