Organization Active NPI

Wellspring of Life Center, PLLC

  • Clinical Social Worker
  • Flower Mound, TX
National Provider Identifier
1124930466
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
WELLSPRING OF LIFE CENTER, PLLC
Practice address
1101 Surrey LN, Building 200
Suite 17
Flower Mound, TX 75022
Phone
(213) 219-0099
NPI assigned
Sep 21, 2026
Last updated
Sep 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Authorized official

Name
Christine Chae, LCSW
Title
Owner
Phone
(213) 219-0099

Specialties & licenses 1

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

Addresses

Primary practice location

1101 Surrey LN, Building 200
Suite 17
Flower Mound, TX 75022

Mailing address

1101 Surrey LN, Building 200
Suite 17
Flower Mound, TX 75022
Phone (213) 219-0099

NPI Registry JSON

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1124930466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SURREY LN, BUILDING 200",
            "address_2": "SUITE 17",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "75022",
            "telephone_number": "213-219-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SURREY LN, BUILDING 200",
            "address_2": "SUITE 17",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "75022",
            "telephone_number": "213-219-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING OF LIFE CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "CHAE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "213-219-0099",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.