Wellspring Mental Health

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WELLSPRING MENTAL HEALTH

Practice address

5400 Phoenix Ave NE
Albuquerque, NM 87110-3144

Phone

(505) 331-7815

NPI assigned

Feb 14, 2019

Organization subpart

No

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

Authorized official

Name

Mary Camille CunninghamNPI 1154452704

Title

Sole MBR

Phone

(505) 331-7815

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mary Camille Cunningham Doing business as

Medicare fee-for-service enrollment

Enrolled in NM

Enrollment records 1

Locations

Practitioners 1

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

• Mary Camille Cunningham, LMFT

  • Mental Health Counselor
  • Albuquerque, NM
  • NPI 1154452704
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550102400000",
    "number": "1114483096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 PHOENIX AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103144",
            "telephone_number": "505-331-7815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 PHOENIX AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871103144",
            "telephone_number": "505-331-7815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-14",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "CAMILLE",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "505-331-7815"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40870502",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mary Camille Cunningham",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Melissia Wells, CSW
• Natasha A Wells, D.O.M
• Nicole S Wells, RDH
• Susan E Wells, LMSW
• Wellspring Grief Journey Support LLC
• Welscare of New Mexico LLC
• Rachel Elizabeth Wemhoff, MD
• Data Dimitri Wenberg, DPT
• Natalie M Wendel
• Aimee Wendelsdorf

• Mental Health Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Mental Health Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.