Organization
WILLOW TREE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE ANN BALDERSON LISW-CP (PSYCHOTHERAPIST COOWNER)
(864) 436-9075
Entity
Organization
Contact information
Practice address
107 E PARK AVE, GREENVILLE, SC 29601-1631
(864) 729-4184
(864) 729-4044
Mailing address
107 E PARK AVE, GREENVILLE, SC 29601-1631
(864) 729-4184
(864) 729-4044
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10138
SC
1041C0700X
Clinical Social Worker
10511
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SW1324
—
SC
05
—
SW1327
—
SC
Enumeration date
10/27/2016
Last updated
10/27/2016
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