NPIMap

Organization Active NPI

Willow Tree Wellness, LLC

  • Psychiatry Physician
  • Concord, NH
National Provider Identifier
1942052766
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
WILLOW TREE WELLNESS, LLC
Practice address
20 Foundry St Ste 230
Concord, NH 03301-5419
Phone
(603) 321-9265
NPI assigned
Apr 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Authorized official

Name
Teresa FrederickNPI 1235902065
Title
Owner
Phone
(603) 321-9265

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)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

20 Foundry St Ste 230
Concord, NH 03301-5419

Mailing address

20 Foundry St Ste 230
Concord, NH 03301-5419

National Provider Directory

National Provider Directory

Locations

20 Foundry St
Ste 230
Concord, NH 03301
Phone (603) 321-9265

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1942052766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 FOUNDRY ST STE 230",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033015419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 FOUNDRY ST STE 230",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033015419",
            "telephone_number": "603-321-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW TREE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-321-9265"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.