| Wellspring Psychology Group LLC | |
|
1340 Celebration Blvd Unit A Florence SC 29501-5585 | |
| (843) 536-1180 | |
| (843) 536-1116 |
| Full Name | Wellspring Psychology Group LLC |
|---|---|
| Speciality | Psychologist |
| Location | 1340 Celebration Blvd, Florence, South Carolina |
| Authorized Official Name and Position | Jason Dean Anderson (PARTNER) |
| Authorized Official Contact | 8127977069 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Psychology Group LLC 1340 Celebration Blvd Unit A Florence SC 29501-5585 Ph: (843) 536-1180 | Wellspring Psychology Group LLC 1340 Celebration Blvd Unit A Florence SC 29501-5585 Ph: (843) 536-1180 |
| NPI Number | 1255756565 |
|---|---|
| Provider Enumeration Date | 02/24/2014 |
| Last Update Date | 02/24/2014 |
| Medicare PECOS PAC ID | 9537382692 |
|---|---|
| Medicare Enrollment ID | O20140519002263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255756565 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1073 (South Carolina) | Primary |
| Provider Name | Jason Dean Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942481882 PECOS PAC ID: 6002905262 Enrollment ID: I20071211000433 |
| Provider Name | Edward L Scearce |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467678672 PECOS PAC ID: 5991884074 Enrollment ID: I20100223000530 |
| Provider Name | Asya Elizabeth Penzo-shumard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376994335 PECOS PAC ID: 6406141571 Enrollment ID: I20160829001255 |
| Provider Name | Leah M. Adams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275023483 PECOS PAC ID: 5496096000 Enrollment ID: I20190409001282 |
| Provider Name | Rebecca Winn Oeffinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184978801 PECOS PAC ID: 4385071133 Enrollment ID: I20200217004913 |
| Provider Name | Keli Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1881298602 PECOS PAC ID: 0244689388 Enrollment ID: I20231214000432 |
| Provider Name | Camille Gonzalez-acevedo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447751698 PECOS PAC ID: 4082063011 Enrollment ID: I20231215000341 |
| Provider Name | Prezillic Daniels |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467715136 PECOS PAC ID: 6305295353 Enrollment ID: I20231215001388 |
| Provider Name | Vanessa Lobo |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912370917 PECOS PAC ID: 7911356837 Enrollment ID: I20231218000485 |
| Provider Name | Veronica Wittscheck |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1023560570 PECOS PAC ID: 4789033614 Enrollment ID: I20231218001141 |
| Provider Name | Natalie Gamble |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851726186 PECOS PAC ID: 9739538679 Enrollment ID: I20231218001353 |
| Provider Name | Mary Rogers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114266707 PECOS PAC ID: 5496104341 Enrollment ID: I20231218001652 |
| Provider Name | Chad W Clardie |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1548922974 PECOS PAC ID: 2567994197 Enrollment ID: I20241021001306 |
| Provider Name | Rebekah Markle |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295491652 PECOS PAC ID: 7214457233 Enrollment ID: I20250220003331 |
| Provider Name | Suzette Mcelveen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437759917 PECOS PAC ID: 1052820586 Enrollment ID: I20250604003829 |
| Provider Name | Carrie Lee Alexander |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1265744015 PECOS PAC ID: 0648745620 Enrollment ID: I20260407002632 |
| Provider Name | Tai Anastacia Yancey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1487269650 PECOS PAC ID: 7810468774 Enrollment ID: I20260602002471 |
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