Provider Demographics
NPI:1972362762
Name:CYNTHIA WILLEY THERAPY PLLC GATHER THERAPY
Entity Type:Organization
Organization Name:CYNTHIA WILLEY THERAPY PLLC GATHER THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMSW
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:WILLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-345-2440
Mailing Address - Street 1:16070 WOODRING CT
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-2965
Mailing Address - Country:US
Mailing Address - Phone:248-345-2440
Mailing Address - Fax:
Practice Address - Street 1:16070 WOODRING CT
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-2965
Practice Address - Country:US
Practice Address - Phone:248-345-2440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty