Provider Demographics
NPI:1548147242
Name:WILLOW TREE PSYCHOLOGICAL SERVICES PLLC
Entity type:Organization
Organization Name:WILLOW TREE PSYCHOLOGICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHI
Authorized Official - Middle Name:CHAN
Authorized Official - Last Name:CSERNANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:646-580-4933
Mailing Address - Street 1:418 BROADWAY # 7529
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12207-2922
Mailing Address - Country:US
Mailing Address - Phone:646-580-4933
Mailing Address - Fax:
Practice Address - Street 1:418 BROADWAY # 7529
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12207-2922
Practice Address - Country:US
Practice Address - Phone:646-580-4933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty