Provider Demographics
NPI:1043472301
Name:WELLSPRING CENTER FOR HEALTH AND WELLBEING, LLC
Entity Type:Organization
Organization Name:WELLSPRING CENTER FOR HEALTH AND WELLBEING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CANDICE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, EDD, APN
Authorized Official - Phone:908-782-1727
Mailing Address - Street 1:83 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1128
Mailing Address - Country:US
Mailing Address - Phone:908-782-1727
Mailing Address - Fax:908-237-1847
Practice Address - Street 1:83 PARK AVE
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1128
Practice Address - Country:US
Practice Address - Phone:908-782-1727
Practice Address - Fax:908-237-1847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty