Wellspring Counseling Services

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0000536 Issued in DE

Legal business name

WELLSPRING COUNSELING SERVICES

Practice address

115 E Glenwood Ave
Smyrna, DE 19977-1424

Phone

(302) 373-8904

NPI assigned

Oct 4, 2017

Organization subpart

No

Name

Michael N Bryson, LPCMHNPI 1588928816

Title

Owner

Phone

(302) 373-8904

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Nathaniel Bryson, LPCMH

  • Mental Health Counselor
  • Dover, DE
  • NPI 1588928816
  NPD Authorized official

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 4, 2017.

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507075200000",
    "number": "1992215917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E RADISON RUN",
            "city": "CLAYTON",
            "state": "DE",
            "postal_code": "199383837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E GLENWOOD AVE",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199771424",
            "telephone_number": "302-373-8904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING COUNSELING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A",
        "authorized_official_last_name": "BRYSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-373-8904",
        "authorized_official_credential": "LPCMH"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "DE",
            "license": "0000536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588928816",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.