| Wellspring Child And Family Psychology, Pc | |
|
615 Emancipation Hwy Ste 101 Fredericksburg VA 22401-8407 | |
| (540) 693-0096 | |
| Not Available |
| Full Name | Wellspring Child And Family Psychology, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 615 Emancipation Hwy, Fredericksburg, Virginia |
| Authorized Official Name and Position | Elisabeth Margaret Jerome (DIRECTOR/PRESIDENT) |
| Authorized Official Contact | 5404783253 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Child And Family Psychology, Pc 615 Emancipation Hwy Ste 101 Fredericksburg VA 22401-8407 Ph: (540) 693-0096 | Wellspring Child And Family Psychology, Pc 615 Emancipation Hwy Ste 101 Fredericksburg VA 22401-8407 Ph: (540) 693-0096 |
| NPI Number | 1477962421 |
|---|---|
| Provider Enumeration Date | 08/04/2014 |
| Last Update Date | 01/07/2022 |
| Certification Date | 01/04/2022 |
| Medicare PECOS PAC ID | 5294036513 |
|---|---|
| Medicare Enrollment ID | O20151210001323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477962421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 0810004284 (Virginia) | Primary |
| Provider Name | Elisabeth M Jerome |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568777621 PECOS PAC ID: 0446447940 Enrollment ID: I20101209000950 |
| Provider Name | Robyn Alycia Zakalik Van Brunt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467766386 PECOS PAC ID: 5991980666 Enrollment ID: I20110421000672 |
| Provider Name | Heather K Henig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699983692 PECOS PAC ID: 7517011588 Enrollment ID: I20140902001751 |
| Provider Name | Tanya L Meline |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952731481 PECOS PAC ID: 6204153893 Enrollment ID: I20150319000326 |
| Provider Name | Nicole E Pernod-liboy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093259590 PECOS PAC ID: 0648547737 Enrollment ID: I20170519001729 |
| Provider Name | Katherine H Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801385349 PECOS PAC ID: 1557616281 Enrollment ID: I20180620001228 |
| Provider Name | Catherine A Conger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487158739 PECOS PAC ID: 4981935913 Enrollment ID: I20191007000399 |
| Provider Name | Katherine Schell-smith |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508905027 PECOS PAC ID: 9931519782 Enrollment ID: I20201105001257 |
| Provider Name | Catharine Lloyd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033784582 PECOS PAC ID: 3678970761 Enrollment ID: I20210915003157 |
| Provider Name | Jessica R Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124478979 PECOS PAC ID: 2860889961 Enrollment ID: I20220419002962 |
| Provider Name | Kelly J Wade |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396025698 PECOS PAC ID: 9537531298 Enrollment ID: I20230207002544 |
| Provider Name | Claire T Hill |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225737216 PECOS PAC ID: 2365801057 Enrollment ID: I20230628002876 |
| Provider Name | Stephanie J Spangler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013554104 PECOS PAC ID: 0648633768 Enrollment ID: I20230822003902 |
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