Organization
WILLOW BIRCH THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHANTEL WINDY LMSW (OWNER, CLINICAL SOCIAL WORKER)
(307) 220-8372
Entity
Organization
Contact information
Practice address
5224 W DARBEE RD, FAIRGROVE, MI 48733-9764
(307) 220-8372
Mailing address
5224 W DARBEE RD, FAIRGROVE, MI 48733-9764
(307) 220-8372
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6801114851
LMSW
MI
Enumeration date
07/25/2022
Last updated
02/02/2023
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