WILLOWSTONE FAMILY SERVICES NPI 1780742874

NPI Information

NPI: 1780742874
Provider Name: WILLOWSTONE FAMILY SERVICES
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
615 N. 18TH ST.
SUITE 101
LAFAYETTE, IN
ZIP 47904
Phone: (765) 423-5361
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WILLOWSTONE FAMILY SERVICES is a mental health counselor in Lafayette, IN. WILLOWSTONE FAMILY SERVICES NPI is 1780742874. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

615 N. 18TH ST.
SUITE 101
LAFAYETTE, IN
ZIP 47904-434
Phone: (765) 423-5361
Fax: (765) 742-8272

The provider's authorized official is Rebecca Sullivan .
The authorized official title is Ceo and has the following contact phone number (765) 423-5361.

The enumeration date for this NPI number is 12/4/2006 and was last updated on 4/20/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	100445220A	MEDICAID	INDIANA
2	251500	MEDICARE UPIN	INDIANA
3	100264050	MEDICAID	INDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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