WELLSPRING COMMUNITY SUPPORT SERVICES, INC. (NPI# 1144451121) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144451121 |
| Entity Type | Organization |
| Organization Name | WELLSPRING COMMUNITY SUPPORT SERVICES, INC. |
| Practice Address |
3rd & St. James Street St. James Complex #206b Mansfield PA 16933 |
| Mailing Address |
Po Box 574 Mansfield PA 16933-0574 |
| Practice Telephone | 5706622821 |
| Practice Fax Number | 5706622822 |
| Mailing Telephone | 5706621064 |
| Mailing Fax Number | 5706620966 |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2011-04-20 |
| Authorized Official Name | FRANK M. VON HENDY (PRESIDENT) |
| Authorized Official Telephone | 5706621064 |
| Authorized Official Credential | LSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | 221170 | PA | Ambulatory Health Care Facilities |
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
221170 | PA | Ambulatory Health Care Facilities |
| N | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
221170 | PA | Ambulatory Health Care Facilities |
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
222350 | PA | Ambulatory Health Care Facilities |
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
221170 | PA | Ambulatory Health Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WELLSPRING COMMUNITY SUPPORT SERVICES, INC. | St James Apts Bldg # B, Mansfield, PA 16933 |
| Street Address |
3RD & ST. JAMES STREET ST. JAMES COMPLEX #206B |
| City | MANSFIELD |
| State | PA |
| Zip Code | 16933 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174937916 | Kyle Ungvarsky | Family Medicine | 416 South Main Street, Mansfield, PA 16933 | 2014-06-19 |
| 1417193707 | Roger Mark Stager | Dentist | 17 N Main St., Mansfield, PA 16933 | 2008-12-17 |
| 1477700185 | David Michael August | Psychiatry & Neurology | 103 A St James Place, Mansfield, PA 16933 | 2008-08-25 |
| 1043472525 | Martha Lloyd Crf Atf Trans | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 105 Saint James Pl, Mansfield, PA 16933 | 2008-06-26 |
| 1518161520 | Elite Therapy PC | Physical Therapist | 285 South Main St., Mansfield, PA 16933 | 2007-06-13 |
| 1659591949 | Tioga County Dept of Human Services | Community/Behavioral Health | St James & Third Street, St James Complex Suite 103a, Mansfield, PA 16933 | 2007-04-27 |
| 1487779880 | Tioga County Dept of Human Services | Community/Behavioral Health | St. James & Third St., Mansfield, PA 16933 | 2007-03-21 |
| 1760507586 | Tioga County Dept of Human Services | Community/Behavioral Health | St. James Place Bldg. A, Mansfield, PA 16933 | 2007-03-20 |
| 1497895783 | Christopher David Jones | Physical Therapist | 285 S Main St, Mansfield, PA 16933 | 2007-02-07 |
| 1598822074 | R M Stager Dmd & J R Coole Dmd Stager & Coole Dentistry | Dentist | 17 North Main Street, Mansfield, PA 16933 | 2007-01-03 |
| Find all providers in zip 16933 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336696343 | Nader Mental Health Servicesllc | Clinic/Center | 14 Claire Ave, Mansfield, MA 02048-2042 | 2016-09-07 |
| 1174122188 | The Center for Individual & Family Services, Inc. | Clinic/Center | 741 Scholl Rd, Mansfield, OH 44907-1571 | 2020-10-21 |
| 1700360583 | Trinity Care Inc | Clinic/Center | 4004 Greenwood Way, Mansfield, TX 76063-5560 | 2018-09-18 |
| 1932696275 | Kehinde Olusoga | Clinic/Center | 4004 Greenwood Way, Mansfield, TX 76063-5560 | 2018-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
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| 1235738360 | Hallie M. Kushner, Ph.d. P.C. | Clinic/Center | 1601 Walnut St Ste 706, Philadelphia, PA 19102-2904 | 2020-10-20 |
| 1780291062 | Grasta Counseling Services, LLC | Clinic/Center | 321 Spruce St Ste 502, Scranton, PA 18503-1445 | 2020-09-30 |
| 1114534328 | Virtual Sofa, LLC | Clinic/Center | 2005 Market St Ste 3140, Philadelphia, PA 19103-7001 | 2020-09-30 |
| 1033725569 | Deirdre Razzi, Lcsw | Clinic/Center | 207 W Plumstead Ave, Lansdowne, PA 19050-1120 | 2020-09-21 |
| 1760096267 | Gail R. Ludwig | Clinic/Center | 689 Oxford Blvd, Pittsburgh, PA 15243-1637 | 2020-09-02 |
| 1922611086 | K.a.d. Counseling, LLC | Clinic/Center | 32 S Broad St Fl 2nd, Nazareth, PA 18064-2117 | 2020-08-28 |
| 1861002461 | Maternal Wellness Center LLC | Clinic/Center | 67 Byberry Rd, Hatboro, PA 19040-3205 | 2020-08-07 |
| 1104435536 | Finding Peace of The Poconos LLC | Clinic/Center | 310 Miller Rd, Stroudsburg, PA 18360-8407 | 2020-07-31 |
| 1942819958 | Shay Selden, Psyd, Med, LLC | Clinic/Center | 1411 S 15th St, Philadelphia, PA 19146-4803 | 2020-07-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.