Organization Active NPI

Wellsprings of Healing LLC

  • Clinical Social Worker
  • Lafayette, CO
National Provider Identifier
1023468576
Registry record updated Jun 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WELLSPRINGS OF HEALING LLC
Practice address
400 E Simpson St Ste 105
Lafayette, CO 80026-2359
Phone
(303) 669-2982
NPI assigned
Jun 15, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2016

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

Authorized official

Name
Suzanne Dumond, MSW
Title
Licensed Clinical Social Worker
Phone
(303) 669-2982

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

400 E Simpson St Ste 105
Lafayette, CO 80026-2359

Mailing address

400 E Simpson St Ste 105
Lafayette, CO 80026-2359
Phone (303) 669-2982

Other identifiers 1

IdentifierTypeStateIssuer
53381785MedicaidCO

National Provider Directory

National Provider Directory

Locations

400 E Simpson St
Ste 105
Lafayette, CO 80026
Phone (303) 669-2982

NPI Registry JSON

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

{
    "created_epoch": "1465948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465948800000",
    "number": "1023468576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E SIMPSON ST STE 105",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262359",
            "telephone_number": "303-669-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E SIMPSON ST STE 105",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800262359",
            "telephone_number": "303-669-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRINGS OF HEALING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-15",
        "last_updated": "2016-06-15",
        "status": "A",
        "authorized_official_last_name": "DUMOND",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "303-669-2982",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "53381785",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.