| Wellsprings Counseling Center, Llc | |
|
22-08 State Rt 208 Suite 16 Fair Lawn NJ 07410-2609 | |
| (201) 956-6363 | |
| (201) 956-6026 |
| Full Name | Wellsprings Counseling Center, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 22-08 State Rt 208, Fair Lawn, New Jersey |
| Authorized Official Name and Position | Lisa Pro-menner (PRESIDENT) |
| Authorized Official Contact | 2019566363 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellsprings Counseling Center, Llc 22-08 State Rt 208 Suite 16 Fair Lawn NJ 07410-2609 Ph: (201) 956-6363 | Wellsprings Counseling Center, Llc 22-08 State Rt 208 Suite 16 Fair Lawn NJ 07410-2609 Ph: (201) 956-6363 |
| NPI Number | 1285844050 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 05/06/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285844050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44SC05191700 (New Jersey) | Primary |
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