WELLSPRING NPI 1003851411

NPI Information

NPI: 1003851411
Provider Name: WELLSPRING

Former Legal Business Name: FAMILY SERVICE AGENCY

Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

Address:
701 E COLUMBIA ST
SPRINGFIELD, OH
ZIP 45503
Phone: (937) 325-5564
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WELLSPRING is a mental health counselor in Springfield, OH. WELLSPRING NPI is 1003851411. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Family Service Agency.

The provider's business location address is:

701 E COLUMBIA ST
SPRINGFIELD, OH
ZIP 45503-404
Phone: (937) 325-5564
Fax: (937) 325-5564

The provider's authorized official is Tiffany Nelson .
The authorized official title is Office Manager and has the following contact phone number (937) 325-5564.

The enumeration date for this NPI number is 6/19/2006 and was last updated on 6/15/2023.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	0284	OHIO	No
2	106H00000X	Marriage & Family Therapist		0284	OHIO	No
3	101YM0800X	Counselor	Mental Health	0284	OHIO	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	10501	MEDICAID	OHIO

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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