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Organization
WILLOWSTONE FAMILY SERVICES
Active
Organization
WILLOWSTONE FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REBECCA SULLIVAN LCSW (CEO)
(765) 423-5361
Entity
Organization
Contact information
Practice address
615 N. 18TH ST., SUITE 101, LAFAYETTE, IN 47904-3434
(765) 423-5361
(765) 742-8272
Mailing address
615 N. 18TH ST., SUITE 101, LAFAYETTE, IN 47904-3434
(765) 423-5361
(765) 742-8272
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100264050
—
IN
05
—
100445220A
—
IN
Enumeration date
12/04/2006
Last updated
05/03/2024
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