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General NPI Number Information
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NPI Number | 1407809213
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Entity Type | Organization
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Legal Business Name | WELLSTONE, INC.
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 06/23/2020
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Provider Practice Location Address
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Address Line | 4040 MEMORIAL PKWY SW
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City | HUNTSVILLE
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State | AL
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Zip | 35802-4364
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Country | US
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Telephone | 256-533-1970
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Fax | 256-532-4141
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Provider Business Mailing Address
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Address Line | 4040 MEMORIAL PKWY SW
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City | HUNTSVILLE
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State | AL
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Zip | 35802-4364
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Country | US
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Telephone | 256-533-1970
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Fax | 256-532-4141
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Authorized Official
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Title or Position | HUMAN RESOURCES MANAGER
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Name | MRS. TORI L LOVELL
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Credential | BS
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Telephone | 256-705-6312
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) 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 | 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 #3
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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 #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #8
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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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