NPI Details
WELLSPRING FAMILY MEDICINE, PC is a psychologist in Oakland, MD. The provider is a psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. WELLSPRING FAMILY MEDICINE, PC NPI is 1265952998. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Wellspring Family Medicine.
The provider's business location address is:
311 N 4TH ST
OAKLAND, MD
ZIP 21550-371
Phone: (301) 334-7855
Fax: (301) 334-7828
The provider's authorized official is Ramona Thomas .
The authorized official title is Operations Manager and has the following contact phone number (301) 501-5110.
The CLIA number assigned to this NPI record is 21D0220085 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 6/23/2017 and was last updated on 7/21/2022.
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 | 1041C0700X | Social Worker | Clinical | 12014 | MARYLAND | No |
| 2 | 103T00000X | Psychologist | | 05746 | MARYLAND | 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 | 3810006442 | MEDICAID | WEST VIRGINIA | |
| 2 | 413901100 | MEDICAID | MARYLAND | |
