Provider Demographics
NPI:1821743063
Name:WILLIS COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:WILLIS COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:682-622-6013
Mailing Address - Street 1:508 MOONRISE DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-5007
Mailing Address - Country:US
Mailing Address - Phone:682-622-6013
Mailing Address - Fax:682-222-7327
Practice Address - Street 1:1720 OAK VILLAGE BLVD STE 200B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-7952
Practice Address - Country:US
Practice Address - Phone:682-622-6013
Practice Address - Fax:682-222-7327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty