Organization
WILLOW & SPRIG
Active
Parent organization
WILLOW & SPRIG
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILLOW & SPRIG
Authorized official
DANIELLE PASQUERELLO LPC (CLINICAL SUPERVISOR)
(602) 862-8926
Entity
Organization
Contact information
Practice address
2 N CENTRAL AVE STE 1925, PHOENIX, AZ 85004-2322
(602) 862-8926
Mailing address
10810 N TATUM BLVD STE 102-628, PHOENIX, AZ 85028-6055
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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