WELLSPRINGS WELLNESS LLC NPI 1144886763

NPI Information

NPI: 1144886763
Provider Name: WELLSPRINGS WELLNESS LLC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 18D2167758

Address:
200 BELMONT AVE
SOMERSET, KY
ZIP 42501
Phone: (606) 687-2038
Get Directions

WELLSPRINGS WELLNESS LLC is a psychiatric/mental health nurse practitioner in Somerset, KY. WELLSPRINGS WELLNESS LLC NPI is 1144886763. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

200 BELMONT AVE
SOMERSET, KY
ZIP 42501-419
Phone: (606) 687-2038
Fax: (606) 200-3654

The provider's authorized official is Tricia L Whitaker .
The authorized official title is Director Of Operations and has the following contact phone number (606) 687-2038.

The CLIA number assigned to this NPI record is 18D2167758 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2019 and was last updated on 5/17/2023.

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	Primary
1	2084P0800X	Psychiatry & Neurology	Psychiatry	No
2	363L00000X	Nurse Practitioner		No
3	363LF0000X	Nurse Practitioner	Family	No
4	207Q00000X	Family Medicine		No
5	101YM0800X	Counselor	Mental Health	No
6	101YP2500X	Counselor	Professional	No
7	103T00000X	Psychologist		No
8	103TC0700X	Psychologist	Clinical	No
9	103TC1900X	Psychologist	Counseling	No
10	1041C0700X	Social Worker	Clinical	No
11	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	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	7100599060	MEDICAID	KENTUCKY

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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