Organization
WELLSPRING COUNSELING KY
Active
Other names
Wellsprings Wellness of Lake Cumberland
Organization subpart
No
Provider details
NPI number
Authorized official
TRICIA L WHITAKER (CHIEF EXECUTIVE OFFICER)
(606) 687-2038
Entity
Organization
Contact information
Practice address
200 BELMONT AVE, SOMERSET, KY 42501-2419
(606) 687-2038
(606) 200-3654
Mailing address
PO BOX 3044, WEST SOMERSET, KY 42564-3044
(606) 687-2038
(606) 200-3654
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
103TC1900X
Counseling Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100504900
—
KY
Enumeration date
01/09/2018
Last updated
05/22/2024
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