person
Ms. Mary Willis, LPC
Professional Counselor in Roanoke, Virginia
NPI 1083700652

Mary Willis is a Professional Counselor based in Christiansburg, VA and is specialized in Professional. Mary Willis practices in Roanoke, VA and has the professional credentials of LPC. The NPI Number for Mary Willis is 1083700652 and holds a License No. 0701003372 (Virginia).

The current practice location address for Mary Willis is 4656 Brambleton Avenue, Roanoke, VA and can be reached out via phone at 540-772-8043 and via fax at 540-772-8242.

Location: 4656 Brambleton Avenue, Roanoke, VA, 24073
person
Provider Profile Details
NPI Number
1083700652
Provider Name
Mary Willis
Credential
LPC
Provider Entity Type
Individual
Gender
Female
Address
4656 Brambleton Avenue, Roanoke, VA, 24073
Phone Number
540-772-8043
Fax Number
540-772-8242
Provider Enumeration Date
10/04/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
087515M 01 VA SOUTHERN HEALTH
488754 01 VA VALUE OPTIONS
7684485 01 TX AETNA
191801 01 VA ANTHEM BCBS
institution
Provider Business Practice Location Address Details
Address
4656 Brambleton Avenue
City
State
Zip
24018
Phone Number
540-772-8043
Fax Number
540-772-8242
person
Provider Business Mailing Address Details
Address
4656 Brambleton Avenue
City
State
Zip
24018
Phone Number
540-772-8043
Fax Number
540-772-8242
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
0701003372 (Virginia)
Definition
Definition to come...
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