Willow Bend Counseling LLC

Primary specialty

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

Legal business name

WILLOW BEND COUNSELING LLC

Practice address

351 Manville Rd Ste 104
Pleasantville, NY 10570-2166

Phone

(914) 825-4800

NPI assigned

Oct 2, 2020

Organization subpart

No

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

Authorized official

Name

Nicole Goudreau-Green, LCSW-RNPI 1437499100

Title

Member/Owner

Phone

(914) 825-4800

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Goudreau-Green, LCSW-R

  • Clinical Social Worker
  • Hartsdale, NY
  • NPI 1437499100
  NPD Authorized official

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601596800000",
    "number": "1710584883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 MAPLE AVE",
            "city": "PEEKSKILL",
            "state": "NY",
            "postal_code": "105664837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 MANVILLE RD STE 104",
            "city": "PLEASANTVILLE",
            "state": "NY",
            "postal_code": "105702166",
            "telephone_number": "914-825-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW BEND COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A",
        "authorized_official_last_name": "GOUDREAU-GREEN",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "914-825-4800",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole@willowbendcounseling.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "351 Manville Rd Ste 104",
            "city": "Pleasantville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "105702166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ami Monique Whittle
• Anthoney Whyte
• Kimberly Wildey, LMHC
• Andy Williams
• Lotoya Shereese Williams
• Jacqueline Wilson
• Samantha Camile Wilson I
• Susan A. Wolf, R.N.
• Kiera Ashley Yahn
• Pearly M. Yee, P.T.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Pleasantville, NY
• Providers in Pleasantville, NY by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.