Provider Demographics
NPI:1538972633
Name:WELLSPRING COUNSELING CENTER, PLLC
Entity type:Organization
Organization Name:WELLSPRING COUNSELING CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CALYE
Authorized Official - Middle Name:MORGAN
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:405-548-5622
Mailing Address - Street 1:2524 N BROADWAY STE 327
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-4177
Mailing Address - Country:US
Mailing Address - Phone:405-548-5622
Mailing Address - Fax:
Practice Address - Street 1:2524 N BROADWAY STE 327
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-4177
Practice Address - Country:US
Practice Address - Phone:405-548-5622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty