Provider Demographics
NPI:1427561299
Name:WELLSPRING CENTER FOR COUNSELING, LLC
Entity Type:Organization
Organization Name:WELLSPRING CENTER FOR COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELLS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:402-750-0279
Mailing Address - Street 1:9N550 CREEKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60124-8331
Mailing Address - Country:US
Mailing Address - Phone:402-750-0279
Mailing Address - Fax:
Practice Address - Street 1:240 EDWARD ST
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-2155
Practice Address - Country:US
Practice Address - Phone:402-750-0279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-14
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 106H00000X
IL166000970261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty