Organization Active NPI

Wellspring Counseling Services, LLC

  • Clinical Social Worker
  • Melbourne, FL
National Provider Identifier
1619385382
Registry record updated Jul 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW10881 Issued in FL
Legal business name
WELLSPRING COUNSELING SERVICES, LLC
Practice address
25 W Alma Dr
Melbourne, FL 32935-6701
Phone
(321) 795-6062
NPI assigned
Jul 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2014

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

Authorized official

Name
Mrs. Crystal Turman, LCSWNPI 1700149762
Title
Owner
Phone
(321) 795-6062

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X SW10881 FL Primary

Addresses

Primary practice location

25 W Alma Dr
Melbourne, FL 32935-6701

Mailing address

25 W Alma Dr
Melbourne, FL 32935-6701
Phone (321) 795-6062

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140923001640 FL Part B Supplier - Clinic/Group Practice 1456570555 Receives reassigned benefits from 1 practitioner
Practice locations: Satellite Beach, FL; Viera, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1406246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406246400000",
    "number": "1619385382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 W ALMA DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329356701",
            "telephone_number": "321-795-6062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 W ALMA DR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329356701",
            "telephone_number": "321-795-6062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-25",
        "last_updated": "2014-07-25",
        "status": "A",
        "authorized_official_last_name": "TURMAN",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-795-6062",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2014; 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.