Provider Demographics
NPI:1497251680
Name:WILLOW TREE COUNSELING
Entity Type:Organization
Organization Name:WILLOW TREE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT-DOWNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:405-652-1185
Mailing Address - Street 1:1401 S DOUGLAS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-5200
Mailing Address - Country:US
Mailing Address - Phone:405-652-1185
Mailing Address - Fax:405-652-1185
Practice Address - Street 1:1401 S DOUGLAS BLVD STE A
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-5200
Practice Address - Country:US
Practice Address - Phone:405-652-1185
Practice Address - Fax:405-652-1185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6219261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)