Healthcare Provider Details

I. General information

NPI: 1689502833
Provider Name (Legal Business Name): WELLSPRING THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2026
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

154 SULLIVAN AVE STE 1
SOUTH WINDSOR CT
06074-1959
US

IV. Provider business mailing address

9 GRANDVIEW TER
VERNON ROCKVILLE CT
06066-3411
US

V. Phone/Fax

Practice location:
  • Phone: 475-253-5616
  • Fax:
Mailing address:
  • Phone: 475-253-5616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MEGAN D LEWIS
Title or Position: THERAPIST
Credential: LMFT
Phone: 475-253-5616