Wellspring Mental Health LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

WELLSPRING MENTAL HEALTH LLC

Practice address

204 W Main St Unit E
Hortonville, WI 54944-8556

Phone

(920) 393-8355

Fax

(920) 580-0150

NPI assigned

Dec 21, 2023

Last updated

Dec 21, 2023By 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

Gretchen Dominowski, LPC

Title

Owner

Phone

(920) 393-8355

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1417726282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 165",
            "city": "HORTONVILLE",
            "state": "WI",
            "postal_code": "549440165",
            "telephone_number": "920-393-8355",
            "fax_number": "920-580-0150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W MAIN ST UNIT E",
            "city": "HORTONVILLE",
            "state": "WI",
            "postal_code": "549448556",
            "telephone_number": "920-393-8355",
            "fax_number": "920-580-0150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "DOMINOWSKI",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "920-393-8355",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Rose Timm, MS CCC-SLP
• Blake C. Treichel, D.D.S.
• Katie Uhlenbrauck
• Jenna Michele Vandenavond, DDS
• Jamie L Vander Sanden, D.C.
• Susan Mary Wisniewski, OTR

• Mental Health Counselor in Hortonville, WI
• Providers in Hortonville, WI by specialty
• Mental Health Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.