Provider Demographics
NPI:1508593740
Name:WELLSPRING APPROACH COUNSELING, PLLC
Entity Type:Organization
Organization Name:WELLSPRING APPROACH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:HENDERSON
Authorized Official - Last Name:MACON
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHCS
Authorized Official - Phone:336-963-4391
Mailing Address - Street 1:PO BOX 3439
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27204-3439
Mailing Address - Country:US
Mailing Address - Phone:336-963-4391
Mailing Address - Fax:
Practice Address - Street 1:180 BROWERS CHAPEL RD APT B
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27205-7984
Practice Address - Country:US
Practice Address - Phone:336-963-4391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty