Provider Demographics
NPI:1760232565
Name:WILLOW ARTS & WELLNES CENTER
Entity Type:Organization
Organization Name:WILLOW ARTS & WELLNES CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TAX ID OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:440-539-2906
Mailing Address - Street 1:806 SHARON DR STE B
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-7701
Mailing Address - Country:US
Mailing Address - Phone:440-539-2906
Mailing Address - Fax:
Practice Address - Street 1:806 SHARON DR STE B
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-7701
Practice Address - Country:US
Practice Address - Phone:440-539-2906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty