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General NPI Number Information
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NPI Number | 1407517840
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Entity Type | Organization
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Legal Business Name | WELLSPRINGS MENTAL HEALTH SOLUTIONS, PLLC
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Dates
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Enumeration Date | 01/07/2022
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 823 ELM ST STE 200
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City | FAYETTEVILLE
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State | NC
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Zip | 28303-4164
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Country | US
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Telephone | 910-580-8195
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Fax |
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Provider Business Mailing Address
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Address Line | 2037 LAKERIDGE DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-0507
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Country | US
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Telephone | 910-885-4849
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MARIAH HAZEN
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Credential | PMHNP-BC
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Telephone | 910-885-4849
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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