Organization Active NPI

Wells Therapy Center, LLC

  • Professional Counselor
  • Fountain Inn, SC
National Provider Identifier
1003622622
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
WELLS THERAPY CENTER, LLC
Practice address
711 Fairview St
Fountain Inn, SC 29644-1541
Phone
(803) 318-5400
NPI assigned
Dec 9, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dennis Wells, LPCNPI 1861711665
Title
Owner
Phone
(803) 318-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

711 Fairview St
Fountain Inn, SC 29644-1541

Mailing address

711 Fairview St
Fountain Inn, SC 29644-1541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250113003247 SC Part B Supplier - Clinic/Group Practice 4385172774 Receives reassigned benefits from 1 practitioner
Practice locations: Fountain Inn, SC

National Provider Directory

National Provider Directory

Locations

711 Fairview St
Fountain Inn, SC 29644
Phone (803) 318-5400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733702400000",
    "number": "1003622622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 FAIRVIEW ST",
            "city": "FOUNTAIN INN",
            "state": "SC",
            "postal_code": "296441541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 FAIRVIEW ST",
            "city": "FOUNTAIN INN",
            "state": "SC",
            "postal_code": "296441541",
            "telephone_number": "803-318-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLS THERAPY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-318-5400",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fountain Inn, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.