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General NPI Number Information
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NPI Number | 1043472301
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Entity Type | Organization
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Legal Business Name | WELLSPRING CENTER FOR HEALTH AND WELLBEING, LLC
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Dates
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Enumeration Date | 06/27/2008
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 83 PARK AVE
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City | FLEMINGTON
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State | NJ
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Zip | 08822-1128
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Country | US
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Telephone | 908-782-1727
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Fax | 908-237-1847
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Provider Business Mailing Address
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Address Line | 83 PARK AVE
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City | FLEMINGTON
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State | NJ
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Zip | 08822-1128
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Country | US
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Telephone | 908-782-1727
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Fax | 908-237-1847
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CANDICE KNIGHT
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Credential | PHD., ED.D., A.P.N
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Telephone | 908-782-1727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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