Healthcare Provider Details

I. General information

NPI: 1326590225
Provider Name (Legal Business Name): MAINSPRING WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2016
Last Update Date: 12/02/2024
Certification Date: 12/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GREENUP ST
COVINGTON KY
41011-2524
US

IV. Provider business mailing address

600 GREENUP ST
COVINGTON KY
41011-2524
US

V. Phone/Fax

Practice location:
  • Phone: 859-349-0700
  • Fax:
Mailing address:
  • Phone: 859-349-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER MORANDI
Title or Position: PARTNER
Credential: LPCC-S
Phone: 859-349-0700