| Willow Tree Wellness & Counseling, Llc | |
|
214 Center St Bloomsburg PA 17815-1752 | |
| (570) 336-9921 | |
| (570) 317-2594 |
| Full Name | Willow Tree Wellness & Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 214 Center St, Bloomsburg, Pennsylvania |
| Authorized Official Name and Position | Nicole Iacovoni (FOUNDER & CHIEF CLINICIAN) |
| Authorized Official Contact | 5703369921 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Tree Wellness & Counseling, Llc 214 Center St Bloomsburg PA 17815-1752 Ph: (570) 336-9921 | Willow Tree Wellness & Counseling, Llc 214 Center St Bloomsburg PA 17815-1752 Ph: (570) 336-9921 |
| NPI Number | 1649521584 |
|---|---|
| Provider Enumeration Date | 10/01/2012 |
| Last Update Date | 10/01/2012 |
| Medicare PECOS PAC ID | 6103275508 |
|---|---|
| Medicare Enrollment ID | O20231211002386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649521584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CW017138 (Pennsylvania) | Primary |
| Provider Name | Terri L Calvert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205914249 PECOS PAC ID: 6002881257 Enrollment ID: I20040831000789 |
| Provider Name | Jessie S Hartman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104051671 PECOS PAC ID: 6901140359 Enrollment ID: I20181212000341 |
| Provider Name | Nicole Iacovoni |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578834784 PECOS PAC ID: 1557710951 Enrollment ID: I20231212000283 |
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