Healthcare Provider Details

I. General information

NPI: 1346171436
Provider Name (Legal Business Name): WELLSPRING COUNSELING AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1713 HOUGH ST
FORT MYERS FL
33901-2509
US

IV. Provider business mailing address

3611 WILD SAGE WAY
ALVA FL
33920-4752
US

V. Phone/Fax

Practice location:
  • Phone: 239-992-0761
  • Fax:
Mailing address:
  • Phone: 239-922-0761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH MCDOWELL
Title or Position: CO-OWNER
Credential: LMHC, LPC
Phone: 239-691-4344