MEDICARE: WELLSPRING PSYCHOLOGICAL AND CONSULTING SERVICES

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	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1699622456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLSPRING PSYCHOLOGICAL AND CONSULTING SERVICES

Provider Business Mailing Address
First Line	:	605 KATES TRACE CIR APT J
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23608-8311
Country	:	US
Telephone Number	:	757-573-9017
Fax Number	:

Provider Business Practice Location Address
First Line	:	605 KATES TRACE CIR APT J
Second Line	:
City	:	NEWPORT NEWS
State	:	VA
Zip	:	23608-8311
Country	:	US
Telephone Number	:	757-573-9017
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	APRIL BREGETTE MARTIN
Credential	:	PSYD
Telephone Number	:	757-573-9017

Provider Enumeration Date	:	03/11/2026
Last Update Date	:	03/11/2026

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Directions to “WELLSPRING PSYCHOLOGICAL AND CONSULTING SERVICES ” Practice Location

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