Active NPI
Willow Creek Counseling Associates, LLC
- Mental Health Counselor
- Sheridan, WY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LCSW 816
- Legal business name
- WILLOW CREEK COUNSELING ASSOCIATES, LLC
- Practice address
- 2161 Coffeen Ave Ste 401
Sheridan, WY 82801-5771 - Phone
- (307) 751-9090
- NPI assigned
- Mar 12, 2015
- Last updated
- Jun 2, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Juli K Wallin-Fisgus, MSW LCSW
- Title
- Co Owner
- Phone
- (307) 751-9090
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LCSW 816 | WY | Primary |
Addresses
Primary practice location
2161 Coffeen Ave Ste 401
Sheridan, WY 82801-5771
Mailing address
245 Broadway, Ste 11
PO Box 6650
Sheridan, WY 82801
Phone (307) 751-9090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
245 Broadway St
Ste 11
Sheridan, WY 82801
Phone (307) 752-7294
2161 Coffeen Ave
Ste 401
Sheridan, WY 82801
Phone (307) 429-2229
Practitioners & affiliated clinicians
Practitioners 7
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.
-
- Clinical Social Worker
- Sheridan, WY
- NPI 1598089807
-
- Clinical Social Worker
- Sheridan, WY
- NPI 1659615037
-
- Student in an Organized Health Care Education/Training Program
- Sheridan, WY
- NPI 1881515781
-
- Counselor
- Sheridan, WY
- NPI 1265910806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426118400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1591056000000",
"number": "1851784003",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 BROADWAY, STE 11",
"address_2": "PO BOX 6650",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "82801",
"telephone_number": "307-751-9090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2161 COFFEEN AVE STE 401",
"city": "SHERIDAN",
"state": "WY",
"postal_code": "828015771",
"telephone_number": "307-751-9090"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILLOW CREEK COUNSELING ASSOCIATES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-03-12",
"last_updated": "2020-06-02",
"certification_date": "2020-06-02",
"status": "A",
"authorized_official_last_name": "WALLIN-FISGUS",
"authorized_official_first_name": "JULI",
"authorized_official_middle_name": "K",
"authorized_official_title_or_position": "CO OWNER",
"authorized_official_telephone_number": "307-751-9090",
"authorized_official_credential": "MSW LCSW"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "WY",
"license": "LCSW 816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheridan, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2020; 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.