| Willow Tree Psychotherapy | |
|
4043 Riverdale Rd # 1076 Ogden UT 84405-1717 | |
| (385) 364-0321 | |
| Not Available |
| Full Name | Willow Tree Psychotherapy |
|---|---|
| Speciality | Counselor |
| Location | 4043 Riverdale Rd # 1076, Ogden, Utah |
| Authorized Official Name and Position | Elisabeth Saucedo (OWNER/CLINICIAN) |
| Authorized Official Contact | 8019418283 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Tree Psychotherapy 4043 Riverdale Rd # 1076 Ogden UT 84405-1717 Ph: (801) 941-8283 | Willow Tree Psychotherapy 4043 Riverdale Rd # 1076 Ogden UT 84405-1717 Ph: (385) 364-0321 |
| NPI Number | 1770232654 |
|---|---|
| Provider Enumeration Date | 03/20/2022 |
| Last Update Date | 03/20/2022 |
| Certification Date | 03/19/2022 |
| Medicare PECOS PAC ID | 3678950821 |
|---|---|
| Medicare Enrollment ID | O20220510000888 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770232654 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Elisabeth C Saucedo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013414408 PECOS PAC ID: 8921354085 Enrollment ID: I20180702003032 |
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