Provider Demographics
NPI:1164286571
Name:WILLOW MENTAL HEALTH COUNSELING
Entity Type:Organization
Organization Name:WILLOW MENTAL HEALTH COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARMIDA
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOLINA-MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-283-0109
Mailing Address - Street 1:1813 EMERALD DR
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83686-7236
Mailing Address - Country:US
Mailing Address - Phone:208-283-0109
Mailing Address - Fax:208-508-8003
Practice Address - Street 1:1813 EMERALD DR
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83686-7236
Practice Address - Country:US
Practice Address - Phone:208-283-0109
Practice Address - Fax:208-508-8003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty