| Willow Tree Llc | |
|
7348 W 21st St N Suite 107 Wichita KS 67205-1793 | |
| (316) 779-2560 | |
| (316) 854-2303 |
| Full Name | Willow Tree Llc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 7348 W 21st St N, Wichita, Kansas |
| Authorized Official Name and Position | Shelby Batt (PARTNER) |
| Authorized Official Contact | 3167792560 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Tree Llc 7348 W 21st St N Suite 107 Wichita KS 67205-1793 Ph: (316) 779-2560 | Willow Tree Llc 7348 W 21st St N Suite 107 Wichita KS 67205-1793 Ph: (316) 779-2560 |
| NPI Number | 1306233077 |
|---|---|
| Provider Enumeration Date | 04/21/2015 |
| Last Update Date | 04/21/2015 |
| Medicare PECOS PAC ID | 1658686324 |
|---|---|
| Medicare Enrollment ID | O20150811004067 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306233077 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (Kansas) | Primary |
| Provider Name | Carrie D Couture |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780892604 PECOS PAC ID: 2961577473 Enrollment ID: I20080819000201 |
| Provider Name | Noelle M Martin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073737300 PECOS PAC ID: 1850451295 Enrollment ID: I20081114000780 |
| Provider Name | Jeremy T Hickey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225077258 PECOS PAC ID: 0143384685 Enrollment ID: I20090129000034 |
| Provider Name | Elizabeth A Wine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760680920 PECOS PAC ID: 0446485056 Enrollment ID: I20131106000587 |
| Provider Name | Shelby N Batt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306285937 PECOS PAC ID: 0244545861 Enrollment ID: I20210810001498 |
| Provider Name | Amanda K Haworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962027847 PECOS PAC ID: 8022433473 Enrollment ID: I20231004001220 |
| Provider Name | Deborah D Ast |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1376854414 PECOS PAC ID: 5799090312 Enrollment ID: I20240215003563 |
| Provider Name | Danielle Kraus |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1407098320 PECOS PAC ID: 5092159236 Enrollment ID: I20240215003718 |
| Provider Name | John W Fleeker |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386835395 PECOS PAC ID: 5991140394 Enrollment ID: I20240226000695 |
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