Organization Active NPI

Wellspring Mental Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1912819517
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
WELLSPRING MENTAL WELLNESS LLC
Practice address
14486 University Gove Place
Tampa, FL 33613
Phone
(813) 997-2099
NPI assigned
Sep 18, 2026
Last updated
Sep 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Authorized official

Name
Brian Clukie
Title
Administrator
Phone
(813) 997-2099

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

14486 University Gove Place
Tampa, FL 33613

Mailing address

5005 W Laurel St Ste 100
Tampa, FL 33607-3896

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1789689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1912819517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 W LAUREL ST STE 100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336073896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14486 UNIVERSITY GOVE PLACE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33613",
            "telephone_number": "813-997-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING MENTAL WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-18",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-17",
        "status": "A",
        "authorized_official_last_name": "CLUKIE",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "813-997-2099"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; 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.