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Willow Tree Family Counseling LLC

Details

Name: Willow Tree Family Counseling LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 15 Oct 2020 (4 years ago)
Date of dissolution: 11 Aug 2023
Entity Number: 000-742-932
Register Number: 000742932
County: Jefferson
Place of Formation: Madison County
Registered Office Street Address: 7129 GADSDEN HIGHWAY SUITE 101TRUSSVILLE, AL 35173
Registered Office Street Address ZIP Code: 35173

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1740885102 2020-12-03 2020-12-03 7129 GADSDEN HWY STE 101, TRUSSVILLE, AL, 351731618, US 7129 GADSDEN HWY STE 101, TRUSSVILLE, AL, 351731618, US

Contacts

Phone +1 251-233-0929

Authorized person

Name MS. ANGELA LACY MCCLINTOCK
Role LICENSED CLINICAL SOCIAL WORKER
Phone 2512330929

Taxonomy

Taxonomy Code 261QM0855X - Adolescent and Children Mental Health Clinic/Center
Is Primary Yes

Agent

Name Role
MCCLINTOCK, ANGELA Agent

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State