Provider Demographics
NPI:1518558980
Name:BLUE WHISPERING WILLOWS COUNSELING LLC
Entity Type:Organization
Organization Name:BLUE WHISPERING WILLOWS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:GARCIA
Authorized Official - Last Name:LAVIND
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:443-884-9048
Mailing Address - Street 1:7618 TIMBERCROSS LN
Mailing Address - Street 2:
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21060-8381
Mailing Address - Country:US
Mailing Address - Phone:443-884-9048
Mailing Address - Fax:
Practice Address - Street 1:7618 TIMBERCROSS LN
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21060-8381
Practice Address - Country:US
Practice Address - Phone:443-884-9048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty