| Organization Name: | WILLOW PATH COUNSELING, LLC |
| NPI Number: | 1720320591 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMIE LYNN ROBERTS (OWNER) |
| Mailing Address: | 4100 Central Ave Shadyside |
| State: | OH US |
| Postal Code: | 439471210 |
| Phone Number: | 3042809798 |
| Fax Number: | |
| NPI Enumeration Date: | 03/20/2013 |
| NPI Last Update Date: | 03/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | E3870 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |