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General NPI Number Information
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NPI Number | 1679023576
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Entity Type | Organization
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Legal Business Name | WELLSPRING COUNSELING & CONSULTING
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 11/06/2017
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Provider Practice Location Address
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Address Line | 1738 BRACKETT AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4626
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Country | US
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Telephone | 715-864-6386
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Fax |
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Provider Business Mailing Address
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Address Line | 1738 BRACKETT AVE
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City | EAU CLAIRE
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State | WI
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Zip | 54701-4626
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Country | US
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Telephone | 715-864-6386
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Fax |
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Authorized Official
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Title or Position | PART OWNER
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Name | CYNTHIA A HUNT
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Credential | LCSW
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Telephone | 715-514-2535
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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 | 4108-125
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License Number State | WI
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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 | 7633-123
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License Number State | WI
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