Wellsprings Holistic Medicine LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

25MB05189200 Issued in NJ

Legal business name

WELLSPRINGS HOLISTIC MEDICINE LLC

Practice address

813 E Gate Dr
Suite B
Mount Laurel, NJ 08054-1238

Phone

(609) 481-5830

Fax

(856) 222-9916

NPI assigned

Apr 20, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Lynn P Delaurentis, MA

Title

Administrator

Phone

(609) 481-5830

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461110400000",
    "number": "1114371697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "813 E GATE DR",
            "address_2": "SUITE B",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541238",
            "telephone_number": "609-481-5830",
            "fax_number": "856-222-9916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 E GATE DR",
            "address_2": "SUITE B",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080541238",
            "telephone_number": "609-481-5830",
            "fax_number": "856-222-9916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRINGS HOLISTIC MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-20",
        "last_updated": "2016-04-20",
        "status": "A",
        "authorized_official_last_name": "DELAURENTIS",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "609-481-5830",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "NJ",
            "license": "SI00144600",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MB05189200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbra M Webb, CF-SLP
• Marisa Latanya Wedderburn
• Wegmans Food Markets, Inc.
• Lisa Weissbach-Efrat, LSW
• Scott E Wellborn, LCSW
• Becky Wesley, LMFT
• West Therapeutic Consultation Services, LLC
• Clara West, DSW
• Lindsay Alexandra West, DO
• Chantay C White, MEDICAL ASSISTANT

• General Practice Physician in Mount Laurel, NJ
• Providers in Mount Laurel, NJ by specialty
• General Practice Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.