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General NPI Number Information
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NPI Number | 1326858903
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Entity Type | Organization
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Legal Business Name | WELLSPRING OF LIFE COUNSELING LLC
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 14 E 4TH ST
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City | EMPORIUM
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State | PA
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Zip | 15834-1443
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Country | US
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Telephone | 814-331-7949
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 343
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City | EMPORIUM
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State | PA
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Zip | 15834-0343
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Country | US
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Telephone | 814-331-7949
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Fax |
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Authorized Official
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Title or Position | OWNER/FOUNDER
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Name | CONSTANCE BOYCE
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Credential | LCSW
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Telephone | 443-204-7767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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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