Organization Active NPI

Wellspace Therapeutics, LLC

  • Mental Health Counselor
  • Sidney, OH
National Provider Identifier
1821647181
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
WELLSPACE THERAPEUTICS, LLC
Practice address
1130 Wapakoneta Ave
Sidney, OH 45365-1461
Phone
(937) 726-0776
NPI assigned
Sep 10, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Authorized official

Name
Amy R Krites, MSW, LISWNPI 1700358272
Title
Owner
Phone
(937) 638-4726

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
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1130 Wapakoneta Ave
Sidney, OH 45365-1461

Mailing address

1130 Wapakoneta Ave
Sidney, OH 45365-1461
Phone (937) 726-0776

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL TherapyNotes.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200131001647 OH Part B Supplier - Clinic/Group Practice 4880020395 Receives reassigned benefits from 2 practitioners
Practice locations: Sidney, OH

National Provider Directory

National Provider Directory

Locations

1130 Wapakoneta Ave
Sidney, OH 45365
Phone (937) 441-9300

110 E Poplar St
Ste 8
Sidney, OH 45365

Practitioners & affiliated clinicians

Practitioners 3

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": "1568073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744675200000",
    "number": "1821647181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 WAPAKONETA AVE",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453651461",
            "telephone_number": "937-726-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 WAPAKONETA AVE",
            "city": "SIDNEY",
            "state": "OH",
            "postal_code": "453651461",
            "telephone_number": "937-726-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPACE THERAPEUTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-10",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "KRITES",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-638-4726",
        "authorized_official_credential": "MSW, LISW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "TherapyNotes.com",
            "affiliation": "N",
            "endpointDescription": "Therapy Notes on a secure websote",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1130 Wapakoneta Ave",
            "city": "Sidney",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453651461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sidney, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2025; 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.