Provider Demographics
NPI:1598334377
Name:WELL SPRING COUNSELING AND EXECUTIVE COACHING LLC
Entity Type:Organization
Organization Name:WELL SPRING COUNSELING AND EXECUTIVE COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SENN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:815-687-6955
Mailing Address - Street 1:114 CARY ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:IL
Mailing Address - Zip Code:60013-2706
Mailing Address - Country:US
Mailing Address - Phone:815-201-2333
Mailing Address - Fax:
Practice Address - Street 1:114 CARY ST
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:IL
Practice Address - Zip Code:60013-2706
Practice Address - Country:US
Practice Address - Phone:815-201-2333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-24
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty