Willow Welch Counseling Clinic LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WILLOW WELCH COUNSELING CLINIC LLC

Practice address

302 S Main St
Malvern, AR 72104-3737

Phone

(501) 229-1515

Fax

(888) 337-2305

NPI assigned

Apr 29, 2024

Organization subpart

No

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

Authorized official

Name

Willow Eve WelchNPI 1801201454

Title

Owner

Phone

(870) 917-7290

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Locations

Practitioners 1

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

• Willow E Welch, LCSW

  • Clinical Social Worker
  • Pine Bluff, AR
  • NPI 1801201454
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714521600000",
    "number": "1952157950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 THUNDERBIRD LOOP",
            "city": "TRASKWOOD",
            "state": "AR",
            "postal_code": "721679051",
            "telephone_number": "870-917-7290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S MAIN ST",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721043737",
            "telephone_number": "501-229-1515",
            "fax_number": "888-337-2305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW WELCH COUNSELING CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "WILLOW",
        "authorized_official_middle_name": "EVE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-917-7290"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katlynn N Williams, LAC
• Keith Williams
• Latonya Williams
• Marsha Joy Williams, SLPA
• Sharon E Williams, APRN-CNP
• Jeannie Wilson
• Kevin Wilson
• Debra Wofford
• Yvonne J Wooten
• Carolyn Wray, MS,LAC,CRC

• Clinical Social Worker in Malvern, AR
• Providers in Malvern, AR by specialty
• Clinical Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; 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.

Verify at the official NPI Registry.