Provider Demographics
NPI:1871152728
Name:WELLSPRING COUNSELING & FAMILY SERVICES PC
Entity type:Organization
Organization Name:WELLSPRING COUNSELING & FAMILY SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA/LCPC
Authorized Official - Phone:406-461-0181
Mailing Address - Street 1:2206 CHOTEAU ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-1430
Mailing Address - Country:US
Mailing Address - Phone:406-461-0181
Mailing Address - Fax:
Practice Address - Street 1:800 E 6TH AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4464
Practice Address - Country:US
Practice Address - Phone:406-461-0181
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-12
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)