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General NPI Number Information
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NPI Number | 1417255258
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Entity Type | Organization
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Legal Business Name | WELLSPRING CHRISTIAN COUNSELING
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 1400 ELBRIDGE PAYNE RD SUITE 200
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City | CHESTERFIELD
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State | MO
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Zip | 63017-8520
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Country | US
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Telephone | 636-449-1250
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Fax | 636-449-1268
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Provider Business Mailing Address
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Address Line | 1400 ELBRIDGE PAYNE RD SUITE 200
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City | CHESTERFIELD
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State | MO
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Zip | 63017-8520
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Country | US
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Telephone | 636-449-1250
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Fax | 636-449-1268
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Authorized Official
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Title or Position | DIRECTOR OF ADMINISTRATION
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Name | JEFF OBERLE
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Credential | LPC
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Telephone | 314-604-5622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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