Provider Demographics
NPI:1710697172
Name:OAK & WILLOW COUNSELING
Entity Type:Organization
Organization Name:OAK & WILLOW COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEGNIN
Authorized Official - Suffix:
Authorized Official - Credentials:LISW, MA
Authorized Official - Phone:831-236-0361
Mailing Address - Street 1:2104 KING AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45420-2453
Mailing Address - Country:US
Mailing Address - Phone:831-236-0361
Mailing Address - Fax:
Practice Address - Street 1:529 E STROOP RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3245
Practice Address - Country:US
Practice Address - Phone:937-234-7763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BREAKFREE FOR WOMEN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty