Wellspring Family Therapy, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WELLSPRING FAMILY THERAPY, INC.

Practice address

4405 W Riverside Dr Ste 203
Burbank, CA 91505-4050

Phone

(818) 238-9895

Fax

(818) 238-9896

NPI assigned

Dec 6, 2017

Organization subpart

No

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

Authorized official

Name

Suzette Bray, LMFT

Title

Ceo

Phone

(818) 856-1800

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1512518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512518400000",
    "number": "1215442785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4405 W RIVERSIDE DR STE 203",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054050",
            "telephone_number": "818-238-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 W RIVERSIDE DR STE 203",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054050",
            "telephone_number": "818-238-9895",
            "fax_number": "818-238-9896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING FAMILY THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-06",
        "last_updated": "2017-12-06",
        "status": "A",
        "authorized_official_last_name": "BRAY",
        "authorized_official_first_name": "SUZETTE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-856-1800",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sarah Wesley
• Wesson Hospice, Inc

• Mental Health Clinic/Center (Including Community Mental Health Center) in Burbank, CA
• Providers in Burbank, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2017; 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.