MEDICARE: WELLSPRING CLINICAL SERVICES L.L.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1285583443
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSPRING CLINICAL SERVICES L.L.C.

Provider Business Mailing Address
First Line	:	501 SILVERSIDE RD STE 25
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19809-1375
Country	:	US
Telephone Number	:	302-330-7471
Fax Number	:	877-539-2555

Provider Business Practice Location Address
First Line	:	501 SILVERSIDE RD STE 25
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19809-1375
Country	:	US
Telephone Number	:	302-330-7471
Fax Number	:	877-539-2555

Authorized Official
Title or Position	:	FOUNDER
Name	:	DOROTHY NYABIOSI
Credential	:	PMHNP
Telephone Number	:	469-540-9979

Provider Enumeration Date	:	01/22/2026
Last Update Date	:	01/22/2026

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