Provider Demographics
NPI:1720613714
Name:WILLOW COUNSELING, LLC
Entity Type:Organization
Organization Name:WILLOW COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:R
Authorized Official - Last Name:WENZL
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LMHP, CPC
Authorized Official - Phone:402-301-7707
Mailing Address - Street 1:444 REGENCY PARKWAY DR STE 104
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3779
Mailing Address - Country:US
Mailing Address - Phone:402-932-2296
Mailing Address - Fax:402-281-0665
Practice Address - Street 1:444 REGENCY PARKWAY DR STE 104
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3779
Practice Address - Country:US
Practice Address - Phone:402-932-2296
Practice Address - Fax:402-281-0665
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health