Provider Demographics
NPI:1619376472
Name:WELLS, APRIL C
Entity Type:Individual
Prefix:DR
First Name:APRIL
Middle Name:C
Last Name:WELLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2775 CRUSE RD STE 1201
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-7144
Mailing Address - Country:US
Mailing Address - Phone:404-917-9355
Mailing Address - Fax:770-564-9356
Practice Address - Street 1:2775 CRUSE RD STE 1201
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-7144
Practice Address - Country:US
Practice Address - Phone:404-917-9355
Practice Address - Fax:770-564-9356
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005400101Y00000X, 101YM0800X, 101YP1600X, 101YP2500X
GAMFT001139101YP1600X, 106H00000X, 101YM0800X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003166388AMedicaid