Healthcare Provider Details

I. General information

NPI: 1962557140
Provider Name (Legal Business Name): WELLSPRING COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2813 PEPPERELL PKWY
OPELIKA AL
36801-6125
US

IV. Provider business mailing address

2813 PEPPERELL PKWY
OPELIKA AL
36801-6125
US

V. Phone/Fax

Practice location:
  • Phone: 334-741-8007
  • Fax: 334-741-8810
Mailing address:
  • Phone: 334-741-8007
  • Fax: 334-741-8810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberL197
License Number StateAL

VIII. Authorized Official

Name: MS. LINDA PAULINE WILKINS
Title or Position: OWNER
Credential: M.S.
Phone: 334-444-4819