NPIMap

Organization Active NPI

Wellworth Health, Inc.

  • Mental Health Counselor
  • San Diego, CA
National Provider Identifier
1568224970
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WELLWORTH HEALTH, INC.
Practice address
3523 Crowell St
San Diego, CA 92103-4729
Phone
(760) 390-2698
NPI assigned
Jan 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Authorized official

Name
Maria Mellano, LICSW
Title
Chief Clinical Officer
Phone
(617) 913-3898

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

3523 Crowell St
San Diego, CA 92103-4729

Mailing address

3523 Crowell St
San Diego, CA 92103-4729
Phone (760) 390-2698

Other names 1

  • Wellworth Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250305002451 IL Part B Supplier - Clinic/Group Practice 7911428016 Receives reassigned benefits from 2 practitioners
Practice locations: Hopewell, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1568224970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3523 CROWELL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034729",
            "telephone_number": "760-390-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3523 CROWELL ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921034729",
            "telephone_number": "760-390-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLWORTH HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "MELLANO",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "617-913-3898",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellworth Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wellworth Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.