| Willow Oak Counseling And Behavioral Services, Llc. | |
|
14323 Ocean Hwy Unit 4103 Pawleys Island SC 29585-4817 | |
| (843) 779-2264 | |
| (866) 580-4842 |
| Full Name | Willow Oak Counseling And Behavioral Services, Llc. |
|---|---|
| Speciality | Counselor |
| Location | 14323 Ocean Hwy Unit 4103, Pawleys Island, South Carolina |
| Authorized Official Name and Position | Jessica Elizabeth Roman (OWNER/LICENSED PROFESSIONAL COUNSEL) |
| Authorized Official Contact | 8437792264 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Oak Counseling And Behavioral Services, Llc. 14323 Ocean Hwy Unit 4103 Pawleys Island SC 29585-4817 Ph: (843) 314-0416 | Willow Oak Counseling And Behavioral Services, Llc. 14323 Ocean Hwy Unit 4103 Pawleys Island SC 29585-4817 Ph: (843) 779-2264 |
| NPI Number | 1235614751 |
|---|---|
| Provider Enumeration Date | 10/01/2018 |
| Last Update Date | 08/12/2019 |
| Medicare PECOS PAC ID | 8820433600 |
|---|---|
| Medicare Enrollment ID | O20240303000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235614751 | NPI | - | NPPES |
| W80629SC1 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Jessica Elizabeth Roman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1164963054 PECOS PAC ID: 9739524513 Enrollment ID: I20240303000057 |
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