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Organization
WELLSPRING FAMILY THERAPY, INC.
Active
Organization
WELLSPRING FAMILY THERAPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZETTE BRAY LMFT (CEO)
(818) 856-1800
Entity
Organization
Contact information
Practice address
4405 W RIVERSIDE DR STE 203, BURBANK, CA 91505-4050
(818) 238-9895
(818) 238-9896
Mailing address
4405 W RIVERSIDE DR STE 203, BURBANK, CA 91505-4050
(818) 238-9895
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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