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Organization
WELLSPRING
Active
Organization
WELLSPRING
Active
Other names
Family Service Agency
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY NELSON (OFFICE MANAGER)
(937) 325-5564
Entity
Organization
Contact information
Practice address
101 N FOUNTAIN AVE, SPRINGFIELD, OH 45502-1118
(937) 325-5564
(937) 325-5564
Mailing address
101 N FOUNTAIN AVE, SPRINGFIELD, OH 45502-1118
(937) 325-5564
(937) 325-5564
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0284
OH
101YM0800X
Mental Health Counselor
Primary
0284
OH
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
0284
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10501
—
OH
Enumeration date
06/19/2006
Last updated
12/16/2024
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