Healthcare Provider Details

I. General information

NPI: 1043915986
Provider Name (Legal Business Name): WELLSPRING COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2023
Last Update Date: 03/31/2023
Certification Date: 03/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W KAGY BLVD STE O
BOZEMAN MT
59715-6026
US

IV. Provider business mailing address

PO BOX 831
MANHATTAN MT
59741-0831
US

V. Phone/Fax

Practice location:
  • Phone: 406-747-0314
  • Fax: 406-287-6980
Mailing address:
  • Phone: 406-581-3525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ALEXA YARNELL
Title or Position: OWNER
Credential: MS, LCPC
Phone: 406-209-8327