NPIMap

Organization Active NPI

Wellspring Therapeutic Partners, LLC

  • Counselor
  • Clinton Township, MI
National Provider Identifier
1801293592
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
6401011566 Issued in MI
Legal business name
WELLSPRING THERAPEUTIC PARTNERS, LLC
Practice address
42815 Garfield Rd
Suite 210
Clinton Township, MI 48038-1143
Phone
(586) 212-8218
Fax
(586) 408-6485
NPI assigned
Nov 25, 2014
Last updated
Feb 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Jessica R Couch, MANPI 1356614051
Title
Owner/Provider
Phone
(586) 212-8218

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
Counselor 101Y00000X 6401011566 MI Primary

Addresses

Primary practice location

42815 Garfield Rd
Suite 210
Clinton Township, MI 48038-1143

Mailing address

42815 Garfield Rd
Suite 210
Clinton Township, MI 48038-1143
Phone (586) 212-8218

National Provider Directory

National Provider Directory

Locations

42815 Garfield Rd
Ste 210
Clinton Twp, MI 48038
Phone (586) 212-8218

Practitioners & affiliated clinicians

Practitioners 23

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 23

NPI Registry JSON

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1801293592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42815 GARFIELD RD",
            "address_2": "SUITE 210",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381143",
            "telephone_number": "586-212-8218",
            "fax_number": "586-408-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42815 GARFIELD RD",
            "address_2": "SUITE 210",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480381143",
            "telephone_number": "586-212-8218",
            "fax_number": "586-408-6485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING THERAPEUTIC PARTNERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-25",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "COUCH",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "586-212-8218",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6401011566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.