Willow River Wellness, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WILLOW RIVER WELLNESS, LLC

Practice address

5775 Avista Dr
Sarasota, FL 34243-3616

Phone

(352) 238-0974

NPI assigned

Oct 25, 2022

Organization subpart

No

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

Authorized official

Name

Robert Foreman

Title

Billing

Phone

(630) 313-0069

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jessica Balos

  • Mental Health Counselor
  • Lakewood Ranch, FL
  • NPI 1841743002
  NPD

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1922725472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5775 AVISTA DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342433616",
            "telephone_number": "352-238-0974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5775 AVISTA DR",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342433616",
            "telephone_number": "352-238-0974"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW RIVER WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "FOREMAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "630-313-0069"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Williams
• Stephanie Nicole Williams, MD
• Thomas H Williams, MD
• Trevor J Williams, APRN
• Tysherika P Williams
• Willowbend Retreats, LLC
• Pamela Wilsen, LMHC
• Patricia Lynn Wilson-Lavigne, M.S. CCC-SLP
• Brian Wilson, D.C.
• Courtney Elizabeth Wilson, RNBSN

• Mental Health Counselor in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.