NPIMap

Organization Active NPI

Wellspring, LLC

  • Behavior Analyst
  • Lafayette, TN
National Provider Identifier
1881178176
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
WELLSPRING, LLC
Practice address
300 Fairlane Dr
Lafayette, TN 37083-1709
Phone
(615) 688-9504
Fax
(615) 688-9503
NPI assigned
Sep 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Authorized official

Name
Dr. Kimberly Hale, PHD, BCBA, LBANPI 1154794675
Title
Owner
Phone
(615) 688-9504

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary
Assistant Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 106E00000X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

300 Fairlane Dr
Lafayette, TN 37083-1709

Mailing address

300 Fairlane Dr
Lafayette, TN 37083-1709
Phone (615) 688-9504

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1537488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666656000000",
    "number": "1881178176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FAIRLANE DR",
            "city": "LAFAYETTE",
            "state": "TN",
            "postal_code": "370831709",
            "telephone_number": "615-688-9504",
            "fax_number": "615-688-9503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FAIRLANE DR",
            "city": "LAFAYETTE",
            "state": "TN",
            "postal_code": "370831709",
            "telephone_number": "615-688-9504",
            "fax_number": "615-688-9503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-21",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A",
        "authorized_official_last_name": "HALE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-688-9504",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, BCBA, LBA"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Assistant Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; 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.