NPIMap

Organization Active NPI

Wellspring Behavioral Health, Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Eagle, ID
National Provider Identifier
1124642293
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
WELLSPRING BEHAVIORAL HEALTH, INC
Practice address
1159 E Iron Eagle Dr Ste 100
Eagle, ID 83616-6868
Phone
(208) 938-2836
Fax
(208) 938-2897
NPI assigned
Jun 3, 2020
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Ashley Croft, DNP, PMHNPNPI 1316311954
Title
Owner/Provider
Phone
(208) 938-2836

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

Practitioners 10

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

National Provider Directory

National Provider Directory

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

NPPES NPI Registry

Primary practice location

1159 E Iron Eagle Dr Ste 100
Eagle, ID 83616-6868

Mailing address

1159 E Iron Eagle Dr Ste 100
Eagle, ID 83616-6868
Phone (208) 938-2836

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 3, 2020.

{
    "created_epoch": "1591142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591142400000",
    "number": "1124642293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1159 E IRON EAGLE DR STE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166868",
            "telephone_number": "208-938-2836",
            "fax_number": "208-938-2897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 E IRON EAGLE DR STE 100",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166868",
            "telephone_number": "208-938-2836",
            "fax_number": "208-938-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING BEHAVIORAL HEALTH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-03",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A",
        "authorized_official_last_name": "CROFT",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "208-938-2836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, PMHNP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.