WILLOW CREEK WELLNESS LLC (NPI# 1710466529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710466529 |
| Entity Type | Organization |
| Organization Name | WILLOW CREEK WELLNESS LLC |
| Practice Address |
The Downtown Executive Center 422 E Vermijo Ste. 208 Colorado Springs CO 80903-3778 |
| Practice Telephone | 7207726020 |
| Practice Fax Number | 7199602405 |
| Mailing Telephone | 7207726020 |
| Mailing Fax Number | 7199602405 |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2020-02-06 |
| Authorized Official Name | KATIE R. KELLY (OWNER) |
| Authorized Official Telephone | 7207720653 |
| Authorized Official Credential | LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
09924585 | CO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 9000173251 | 05 |
| Street Address |
THE DOWNTOWN EXECUTIVE CENTER 422 E VERMIJO STE. 208 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80903-3778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235752437 | Lisa Mae Bunch | Behavior Technician | 102 South Tajon St. Ste 1100, Colorado Springs, CO 80903 | 2020-05-21 |
| 1164045407 | Lajanae Davis | Behavior Technician | 102 S. Tajon Street Ste. 1100, Colorado Springs, CO 80903 | 2020-05-21 |
| 1144855321 | Quinn Macdonald | Specialist/Technologist | 1332 N Weber Street, Colorado Springs, CO 80903 | 2020-03-08 |
| 1043784994 | Neuro Peak Performance, LLC | Counselor | 801 N. Weber St Suite 101, Colorado Springs, CO 80903 | 2019-01-14 |
| 1356828297 | Heart of The Phoenix, LLC | Social Worker | 1422 N Hancock Ave Ste 1, Colorado Springs, CO 80903 | 2018-07-24 |
| 1699269290 | Jenevieve Marie Briand | Day Training/Habilitation Specialist | 427 E Colorado Ave Ste 225, Colorado Springs, CO 80903 | 2018-06-18 |
| 1669983292 | Robin Dina Shankman | Massage Therapist | 127 E. Las Animas, Colorado Springs, CO 80903 | 2017-10-23 |
| 1023559804 | Sean Michael Blumahrdt | Specialist/Technologist, Other | 13 South Tejon St, Ste 501, Colorado Springs, CO 80903 | 2017-03-14 |
| 1366980682 | Edge Medical Services | Clinic/Center | 152 West Colorado Ave, Colorado Springs, CO 80903 | 2017-02-07 |
| 1093267890 | Brittany Nicole Holmes | Behavioral Analyst | 938 S Sierra Madre, Colorado Springs, CO 80903 | 2016-10-27 |
| Find all providers in zip 80903 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545270 | Shannon Marie Scott | Social Worker | 5741 Stable Ct, Colorado Springs, CO 80920-8049 | 2020-10-13 |
| 1942817291 | Chelsea Witt | Social Worker | 5166 Mira Loma Cir, Colorado Springs, CO 80918-2249 | 2020-09-29 |
| 1841802923 | Amber Wilson | Social Worker | 6072 Cider Mill Pl, Colorado Springs, CO 80925-1419 | 2020-08-19 |
| 1255942249 | Elizabeth Ann Armstrong | Social Worker | 439 Mountain Pass Vw, Colorado Springs, CO 80906-7779 | 2020-08-12 |
| 1851900583 | Dannis Schanel | Social Worker | 7123 Sand Crest Vw, Colorado Springs, CO 80923-8810 | 2020-07-29 |
| 1366051328 | Alexis Danielle Olson | Social Worker | 2910 Cortina Dr, Colorado Springs, CO 80918-1804 | 2020-07-27 |
| 1346858610 | Robyn Mayeux | Social Worker | 6060 Snowbird Dr, Colorado Springs, CO 80918-1503 | 2020-07-22 |
| 1245856863 | Melissa Bannerot | Social Worker | 5540 N Academy Blvd Ste 250, Colorado Springs, CO 80918-3696 | 2020-06-19 |
| 1356966303 | Amy Flores | Social Worker | 5315 Solar Ridge Dr, Colorado Springs, CO 80917-1438 | 2020-06-15 |
| 1174145403 | Tiffany Nicole Fontenot | Social Worker | 7047 Wagon Ridge Dr, Colorado Springs, CO 80923-8743 | 2020-05-08 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80903 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.