| Wellspring Behavior Health Llc | |
|
1600 S 70th St Ste 200 Lincoln NE 68506-1568 | |
| (402) 580-4453 | |
| Not Available |
| Full Name | Wellspring Behavior Health Llc |
|---|---|
| Speciality | Counselor |
| Location | 1600 S 70th St Ste 200, Lincoln, Nebraska |
| Authorized Official Name and Position | Eric James Harmes (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4025804453 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Behavior Health Llc 1600 S 70th St Ste 200 Lincoln NE 68506-1568 Ph: (402) 580-4453 | Wellspring Behavior Health Llc 1600 S 70th St Ste 200 Lincoln NE 68506-1568 Ph: (402) 580-4453 |
| NPI Number | 1144876459 |
|---|---|
| Provider Enumeration Date | 08/13/2019 |
| Last Update Date | 09/07/2021 |
| Certification Date | 09/07/2021 |
| Medicare PECOS PAC ID | 2264868157 |
|---|---|
| Medicare Enrollment ID | O20200313000791 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144876459 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Huong X Mack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174928287 PECOS PAC ID: 1456673581 Enrollment ID: I20141201000898 |
| Provider Name | Tawni Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912363342 PECOS PAC ID: 3274837521 Enrollment ID: I20160205001592 |
| Provider Name | Dulce Clarence |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114349982 PECOS PAC ID: 8224472915 Enrollment ID: I20240221002524 |
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