WELLSPRING COUNSELING LLC NPI 1790774115

NPI Information

NPI: 1790774115
Provider Name: WELLSPRING COUNSELING LLC

Former Legal Business Name: BRYCE M. MITCHELL DBA WELLSPRING PSYCHOTHERAPY & COUNSELING CENTER

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
5610 MEDICAL CIRCLE #25
MADISON, WI
ZIP 53719
Phone: (608) 274-5871
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WELLSPRING COUNSELING LLC is a mental health (including community mental health center) clinic center in Madison, WI. WELLSPRING COUNSELING LLC NPI is 1790774115. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Bryce M. Mitchell Dba Wellspring Psychotherapy & Counseling Center.

The provider's business location address is:

5610 MEDICAL CIRCLE #25
MADISON, WI
ZIP 53719-295
Phone: (608) 274-5871
Fax: (608) 274-5764

The provider's authorized official is Ryel M Estes .
The authorized official title is Owner and has the following contact phone number (608) 274-5871.

The enumeration date for this NPI number is 10/18/2005 and was last updated on 6/6/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	1983	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000088302	MEDICARE ID-TYPE UNSPECIFIED	WISCONSIN
2	42198500	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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