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General NPI Number Information
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NPI Number | 1275224867
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Entity Type | Organization
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Legal Business Name | WELLSPRING THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 6918 SHALLOWFORD RD STE 317
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City | CHATTANOOGA
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State | TN
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Zip | 37421-1783
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Country | US
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Telephone | 423-503-3199
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Fax | 423-855-7976
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Provider Business Mailing Address
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Address Line | 6918 SHALLOWFORD RD STE 317
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City | CHATTANOOGA
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State | TN
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Zip | 37421-1783
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Country | US
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Telephone | 423-503-3199
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Fax | 423-855-7976
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | CATHERINE H ROGERS
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Credential | LCSW
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Telephone | 423-855-7977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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