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WILLOW TREE HEALING CENTER LLC NPI 1912149345


NPI Information

NPI: 1912149345
Provider Name: WILLOW TREE HEALING CENTER, LLC

Former Legal Business Name: TRACEY WILKINS, LICSW, LLC

Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
1821 UNIVERSITY AVE W
SUITE S329
SAINT PAUL, MN
ZIP 55104
Phone: (651) 222-9885
Get Directions

WILLOW TREE HEALING CENTER, LLC is a clinical social worker in Saint Paul, MN. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. WILLOW TREE HEALING CENTER, LLC NPI is 1912149345. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Tracey Wilkins, Licsw, Llc.

The provider's business location address is:

1821 UNIVERSITY AVE W
SUITE S329
SAINT PAUL, MN
ZIP 55104-801
Phone: (651) 222-9885
Fax: (888) 977-2056

The provider's authorized official is Tracey Wilkins .
The authorized official title is Clinical Services Director and has the following contact phone number (651) 222-9985.

The enumeration date for this NPI number is 3/31/2009 and was last updated on 2/19/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical15043MINNESOTANo
21041C0700XSocial WorkerClinical13119MINNESOTAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1312174700MEDICAIDMINNESOTA

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: 11/14/2023

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