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General NPI Number Information
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NPI Number | 1154201978
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Entity Type | Organization
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Legal Business Name | WELLSPRING OF PEACE AND HOPE BEHAVIORAL CARE, PLLC
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 2000 S LAKELINE BLVD APT 717
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City | CEDAR PARK
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State | TX
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Zip | 78613-3687
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Country | US
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Telephone | 512-759-8622
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 S LAKELINE BLVD APT 717
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City | CEDAR PARK
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State | TX
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Zip | 78613-3687
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Country | US
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Telephone | 301-873-5020
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Fax |
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Authorized Official
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Title or Position | CEO/SOLE MEMBER
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Name | DR. ROBBIN VIRGINIA ROSE-GROSS
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Credential | PHD, MA, LPC
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Telephone | 301-873-5020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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