| Wellspring Therapeutic Partners, Llc | |
|
42815 Garfield Rd Suite 210 Clinton Township MI 48038-1143 | |
| (586) 212-8218 | |
| (586) 408-6485 |
| Full Name | Wellspring Therapeutic Partners, Llc |
|---|---|
| Speciality | Counselor |
| Location | 42815 Garfield Rd, Clinton Township, Michigan |
| Authorized Official Name and Position | Jessica R Couch (OWNER/PROVIDER) |
| Authorized Official Contact | 5862128218 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Therapeutic Partners, Llc 42815 Garfield Rd Suite 210 Clinton Township MI 48038-1143 Ph: (586) 212-8218 | Wellspring Therapeutic Partners, Llc 42815 Garfield Rd Suite 210 Clinton Township MI 48038-1143 Ph: (586) 212-8218 |
| NPI Number | 1801293592 |
|---|---|
| Provider Enumeration Date | 11/25/2014 |
| Last Update Date | 02/04/2016 |
| Medicare PECOS PAC ID | 2567726326 |
|---|---|
| Medicare Enrollment ID | O20180502000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801293592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | 6401011566 (Michigan) | Primary |
| Provider Name | Zachary Woodby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356780035 PECOS PAC ID: 9133466386 Enrollment ID: I20190124003904 |
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