| Willow Emotional & Relational Health, Llc | |
|
804 High St Baldwin City KS 66006-3101 | |
| (785) 594-5357 | |
| Not Available |
| Full Name | Willow Emotional & Relational Health, Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 804 High St, Baldwin City, Kansas |
| Authorized Official Name and Position | Nicole Leann Crites (OWNER/THERAPIST) |
| Authorized Official Contact | 7855945357 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Emotional & Relational Health, Llc Po Box 634 Baldwin City KS 66006-0634 Ph: (785) 594-5357 | Willow Emotional & Relational Health, Llc 804 High St Baldwin City KS 66006-3101 Ph: (785) 594-5357 |
| NPI Number | 1003492729 |
|---|---|
| Provider Enumeration Date | 03/23/2021 |
| Last Update Date | 03/23/2021 |
| Certification Date | 03/23/2021 |
| Medicare PECOS PAC ID | 9739609165 |
|---|---|
| Medicare Enrollment ID | O20250227003802 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003492729 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
| Provider Name | Grace Delia Vandusen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740027267 PECOS PAC ID: 8820522634 Enrollment ID: I20241114004627 |
| Provider Name | Nicole Crites |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902116650 PECOS PAC ID: 8527316454 Enrollment ID: I20250227003851 |
| Provider Name | Meredith Hodges |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427540400 PECOS PAC ID: 6901320555 Enrollment ID: I20250404002308 |
| Provider Name | Jaquelynn Elizabeth Cornelius |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184374241 PECOS PAC ID: 9537679501 Enrollment ID: I20250609002666 |
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