Provider Demographics
NPI:1003492729
Name:WILLOW EMOTIONAL & RELATIONAL HEALTH, LLC
Entity type:Organization
Organization Name:WILLOW EMOTIONAL & RELATIONAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:LEANN
Authorized Official - Last Name:CRITES
Authorized Official - Suffix:
Authorized Official - Credentials:LCMFT
Authorized Official - Phone:785-594-5357
Mailing Address - Street 1:PO BOX 634
Mailing Address - Street 2:
Mailing Address - City:BALDWIN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66006-0634
Mailing Address - Country:US
Mailing Address - Phone:785-594-5357
Mailing Address - Fax:
Practice Address - Street 1:804 HIGH ST
Practice Address - Street 2:
Practice Address - City:BALDWIN CITY
Practice Address - State:KS
Practice Address - Zip Code:66006-3101
Practice Address - Country:US
Practice Address - Phone:785-594-5357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty