Organization
WILLOW TREE THERAPY GROUP, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA CLAYTON LPC-A (OWNER/COUNSELOR)
(843) 560-4339
Entity
Organization
Contact information
Practice address
138 WATEREE DR, SANTEE, SC 29142-9309
(843) 560-4339
Mailing address
138 WATEREE DR, SANTEE, SC 29142-9309
(843) 560-4339
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255055141
INDIVIDUAL NPI
SC
Enumeration date
10/03/2022
Last updated
10/03/2022
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