WELLSPRINGS WELLNESS LLC NPI 1144886763

NPI Information

  • NPI: 1144886763
  • Provider Name: WELLSPRINGS WELLNESS LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • CLIA Number: 18D2167758
  • Address: 200 BELMONT AVE
    SOMERSET, KY
    ZIP 42501
  • Phone: (606) 687-2038

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NPI Details

WELLSPRINGS WELLNESS LLC is a psychiatric/mental health nurse practitioner in Somerset, KY. WELLSPRINGS WELLNESS LLC NPI is 1144886763. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

200 BELMONT AVE
SOMERSET, KY
ZIP 42501-419
Phone: (606) 687-2038
Fax: (606) 200-3654

The provider's authorized official is Tricia L Whitaker .
The authorized official title is Chief Executive Officer and has the following contact phone number (606) 687-2038.

The CLIA number assigned to this NPI record is 18D2167758 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/20/2019 and was last updated on 5/10/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthNo
2101YP2500XCounselorProfessionalNo
3103T00000XPsychologistNo
4103TC0700XPsychologistClinicalNo
5103TC1900XPsychologistCounselingNo
61041C0700XSocial WorkerClinicalNo
7207Q00000XFamily MedicineNo
82084P0800XPsychiatry & NeurologyPsychiatryNo
9363L00000XNurse PractitionerNo
10363LF0000XNurse PractitionerFamilyNo
11363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17100599060MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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