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General NPI Number Information
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NPI Number | 1912123241
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Entity Type | Organization
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Legal Business Name | WELLSPRING OF HENDERSON COUNTY, INC.
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 220 3RD AVE W # A
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City | HENDERSONVILLE
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State | NC
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Zip | 28739-4308
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Country | US
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Telephone | 828-692-7255
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1778
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City | HENDERSONVILLE
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State | NC
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Zip | 28793-1778
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Country | US
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Telephone | 828-692-7255
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Fax | 828-692-7830
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Authorized Official
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Title or Position | PRESIDENT, DIRECTOR
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Name | PERSIS ANNE DIDIER
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Credential | LCSW
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Telephone | 828-692-7255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C004582
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License Number State | NC
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