Provider Demographics
NPI:1740485804
Name:WELL SPRING FAMILY COUNSELING CENTER
Entity type:Organization
Organization Name:WELL SPRING FAMILY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:WUNDERLICH-PIPKIN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-859-2417
Mailing Address - Street 1:15015 MARLEBONE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-2021
Mailing Address - Country:US
Mailing Address - Phone:832-859-2417
Mailing Address - Fax:281-583-8122
Practice Address - Street 1:15015 MARLEBONE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-2021
Practice Address - Country:US
Practice Address - Phone:832-859-2417
Practice Address - Fax:281-583-8122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX09720305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization