Mary Willoughby Prentiss, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0701010029 Issued in VA

Practice address

9228 George Washington Memorial Hwy
Gloucester, VA 23061-4162

Phone

(804) 695-8120

Fax

(804) 695-8122

NPI assigned

Oct 28, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Willow Tree Healing Center LLC

  • Mental Health Counselor
  • Gloucester, VA
  • NPI 1144807553
  NPD Authorized official

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

{
    "created_epoch": "1603843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783296000000",
    "number": "1710587795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 REBECCA DR",
            "city": "SEAFORD",
            "state": "VA",
            "postal_code": "236962313",
            "telephone_number": "252-619-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9228 GEORGE WASHINGTON MEMORIAL HWY",
            "city": "GLOUCESTER",
            "state": "VA",
            "postal_code": "230614162",
            "telephone_number": "804-695-8120",
            "fax_number": "804-695-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRENTISS",
        "first_name": "MARY",
        "middle_name": "WILLOUGHBY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-28",
        "last_updated": "2026-07-06",
        "certification_date": "2026-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701010029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Claire Pinel
• Jennifer R Pittman-Dixon, PMHNP
• Heather Poe, NP
• Wendell T Poulsen Jr., M.D.
• Karla Marie Pray, NP
• Prime Orthodontics PLLC
• Sebastian Prokop, MD
• Tammy L Pruett-Ware, LPC
• Ava Michele Pugliese
• Cathyrn Fields Radford, M. ED. CCC-SLP

• All providers in Gloucester, VA
• Professional Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2026; 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.