Mountain Spring Wellness LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MOUNTAIN SPRING WELLNESS LLC

Practice address

1617 Dowsville Rd
South Duxbury, VT 05660-9165

Phone

(802) 310-6089

NPI assigned

Nov 1, 2018

Last updated

Jul 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Erick James Lattrell, LICSWNPI 1679040646

Title

Psychotherapist/Owner

Phone

(802) 310-6089

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Erick James Lattrell, LICSW

  • Clinical Social Worker
  • Essex Junction, VT
  • NPI 1679040646
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626393600000",
    "number": "1326515800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 734",
            "city": "WATERBURY",
            "state": "VT",
            "postal_code": "056760734",
            "telephone_number": "802-310-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 DOWSVILLE RD",
            "city": "SOUTH DUXBURY",
            "state": "VT",
            "postal_code": "056609165",
            "telephone_number": "802-310-6089"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10 Pearl St",
            "address_purpose": "LOCATION",
            "city": "Essex Junction",
            "state": "VT",
            "postal_code": "054523604",
            "country_code": "US",
            "telephone_number": "802-310-6089",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MOUNTAIN SPRING WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-01",
        "last_updated": "2021-07-16",
        "certification_date": "2021-07-16",
        "status": "A",
        "authorized_official_last_name": "LATTRELL",
        "authorized_official_first_name": "ERICK",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/OWNER",
        "authorized_official_telephone_number": "802-310-6089",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amberley Noel Mortensen, LATC

• Clinical Social Worker in South Duxbury, VT
• Providers in South Duxbury, VT by specialty
• Clinical Social Worker in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2021; 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.