WILLOW BEND CENTER NPI 1023300720

Counselor (Professional) in Tyler, TX

NPI 1023300720 Organization Counselor Professional

About WILLOW BEND CENTER

Willow Bend Center is a provider established in Tyler, Texas specializing in counselor (professional) . The NPI number of Willow Bend Center is 1023300720 and was assigned on May 2011. The practitioner's primary taxonomy code is 101YP2500X with license number 65784 (TX). The provider is registered as an organization and their NPI record was last updated 10 years ago. Willow Bend Center operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. James Preston Florence Ph.d (Executive Director)

NPI

1023300720

Provider NameWILLOW BEND CENTER
Provider Location Address2902 STATE HIGHWAY 31 E TYLER, TX 75702
Provider Mailing Address2902 STATE HIGHWAY 31 E TYLER, TX 75702
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date05-12-2011
Last Update Date05-12-2011


Primary Taxonomy

Taxonomy Code101YP2500X
ClassificationCounselor
TypeBehavioral Health & Social Service Providers
SpecializationProfessional
License No.65784
License StateTX

Business Address

WILLOW BEND CENTER
2902 STATE HIGHWAY 31 E
TYLER, TX
ZIP 75702
Phone: (903) 596-8900
Fax: (903) 596-8903

Get Directions


Mailing Address

WILLOW BEND CENTER
2902 STATE HIGHWAY 31 E
TYLER, TX
ZIP 75702
Phone: (903) 596-8900
Fax: (903) 596-8903



Authorized Official

Authorized Official NameDR. JAMES PRESTON FLORENCE PH.D
Authorized Official TitleEXECUTIVE DIRECTOR
Authorized Official Phone(903) 596-8900

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Other Providers at the same location


The following 3 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1356648521MRS. ASHLEY ELIZABETH RUBIN LPC
Individual
Counselor (Professional)2902 STATE HIGHWAY 31 E
TYLER, TX 75702
(903) 596-8900
1649562349MRS. JANE D SIMMONS LPC
Individual
Counselor (Professional)2902 STATE HIGHWAY 31 E
TYLER, TX 75702
(903) 596-8900
1942633243 TAYLOR CAITLIN THOMAS LPC
Individual
Counselor (Professional)2902 STATE HIGHWAY 31 E
TYLER, TX 75702
(903) 596-8900

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.