Provider Demographics
NPI:1417255258
Name:WELLSPRING CHRISTIAN COUNSELING
Entity Type:Organization
Organization Name:WELLSPRING CHRISTIAN COUNSELING
Other - Org Name:WELLSPRING CHRISTIAN COUNSELING
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:OBERLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:314-604-5622
Mailing Address - Street 1:1400 ELBRIDGE PAYNE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8520
Mailing Address - Country:US
Mailing Address - Phone:636-449-1250
Mailing Address - Fax:636-449-1268
Practice Address - Street 1:1400 ELBRIDGE PAYNE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-8520
Practice Address - Country:US
Practice Address - Phone:636-449-1250
Practice Address - Fax:636-449-1268
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLSPRING CHRISTIAN COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty