NPIMap

Organization Active NPI

Wellstone, Inc.

Doing business as WellStone Behavioral Health

  • Mental Health Counselor
  • Huntsville, AL
National Provider Identifier
1407809213
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WELLSTONE, INC.
Doing business as
WellStone Behavioral Health
Practice address
4040 Memorial Pkwy SW
Huntsville, AL 35802-4364
Phone
(256) 533-1970
Fax
(256) 532-4141
NPI assigned
May 19, 2006
Last updated
Jun 23, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Authorized official

Name
Mrs. Tori L Lovell, BS
Title
Human Resources Manager
Phone
(256) 705-6312

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X Primary
Clinical Psychologist 103TC0700X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X
Psychiatry Physician 2084P0800X
Child & Adolescent Psychiatry Physician 2084P0804X
Geriatric Psychiatry Physician 2084P0805X

Addresses

Primary practice location

4040 Memorial Pkwy SW
Huntsville, AL 35802-4364

Mailing address

4040 Memorial Pkwy SW
Huntsville, AL 35802-4364
Phone (256) 533-1970

Other practice location 1

1909 Commerce Ave
Cullman, AL 35055-6151
Phone (256) 734-4688

Other identifiers 1

IdentifierTypeStateIssuer
330000014MedicaidAL

Other names 1

  • WellStone Behavioral Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040324000453 AL Part B Supplier - Clinic/Group Practice 9739070046 Receives reassigned benefits from 38 practitioners
Practice locations: Cullman, AL; Huntsville, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D2133479Wellstone Behavioral Health4040 South Memorial Parkway, Huntsville, AL 35802Certificate of waiverJul 12, 2027
01D2306688Wellstone, Inc1909 Commerce Ave, NW, Cullman, AL 35055Certificate of waiverJun 23, 2028

National Provider Directory

National Provider Directory

Locations

3911 Triana Blvd SW
Huntsville, AL 35805
Phone (256) 705-6459

4040 Memorial Pkwy SW
Huntsville, AL 35802
Phone (256) 533-1970

4040 Memorial Pkwy SW
Ste B
Huntsville, AL 35802
Phone (256) 705-6363

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1407809213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 MEMORIAL PKWY SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024364",
            "telephone_number": "256-533-1970",
            "fax_number": "256-532-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 MEMORIAL PKWY SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358024364",
            "telephone_number": "256-533-1970",
            "fax_number": "256-532-4141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 Commerce Ave",
            "address_purpose": "LOCATION",
            "city": "Cullman",
            "state": "AL",
            "postal_code": "350556151",
            "country_code": "US",
            "telephone_number": "256-734-4688",
            "fax_number": "256-736-5638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLSTONE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "LOVELL",
        "authorized_official_first_name": "TORI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "HUMAN RESOURCES MANAGER",
        "authorized_official_telephone_number": "256-705-6312",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330000014",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellStone Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellStone Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.