WELLSPRING FARM LLC (NPI# 1730346339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730346339 |
| Entity Type | Organization |
| Organization Name | WELLSPRING FARM LLC |
| Other Organization Name | WELLSPRING FARM LEARNING CENTER |
| Practice Address |
42 Hiller Rd Rochester MA 02770 |
| Practice Telephone | 5087635896 |
| Practice Fax Number | 5087635896 |
| Mailing Telephone | 5087635896 |
| Mailing Fax Number | 5087635896 |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |
| Authorized Official Name | JAMES EDWARD VOGEL (FOUNDER EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5087635896 |
| Authorized Official Credential | MA CAGS LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
MA | Behavioral Health & Social Service Providers | |
| N | 163W00000X | Registered Nurse | MA | Nursing Service Providers | |
| N | 208000000X | Pediatrics | MA | Allopathic & Osteopathic Physicians | |
| N | 225100000X | Physical Therapist | MA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| N | 225X00000X | Occupational Therapist | MA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| N | 235Z00000X | Speech-Language Pathologist | MA | Speech, Language and Hearing Service Providers | |
| Y | 251S00000X | Community/Behavioral Health | MA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MA DMR AUTISM WAIVER NUMBER | WWELL001A | 01 |
| MA | 1016266 | 05 | |
| MA | MA STATE VENDOR | VCG000188774AD | 01 |
| MA | COMMUNITY MEDICAL ALLIANCE | 0038463 | 01 |
| Other Name | Type Code |
|---|---|
| Wellspring Farm Learning Center | Other Name - Individual/Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | WELLSPRING FARM LLC | 493 Berry Rd, Chehalis, WA 98532-8925 |
| Street Address |
42 HILLER RD |
| City | ROCHESTER |
| State | MA |
| Zip Code | 02770 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457552242 | Rachael Leblanc | Social Worker | 42 Hiller Rd, Rochester, MA 02770-4023 | 2007-05-30 |
| 1073082921 | Karen H Stack | Social Worker | 42 Hiller Rd, Rochester, MA 02770-4023 | 2018-11-21 |
| 1437603305 | Jennifer Terkelsen | Social Worker | 42 Hiller Rd, Rochester, MA 02770-4023 | 2016-08-09 |
| 1982954400 | Emily Christine Marsicano | Marriage & Family Therapist | 42 Hiller Rd, Rochester, MA 02770-4023 | 2012-09-12 |
| 1578822151 | Wellspring Farm Learning Center | Counselor | 42 Hiller Rd, Rochester, MA 02770-4023 | 2012-05-16 |
| 1205117264 | Lisa Roy | Speech-Language Pathologist | 42 Hiller Rd, Rochester, MA 02770-4023 | 2011-09-06 |
| 1205167681 | Gretchen Ann Sullivan | Counselor | 42 Hiller Rd, Rochester, MA 02770-4023 | 2010-01-25 |
| 1194056572 | James Edward Vogel | Counselor | 42 Hiller Rd, Rochester, MA 02770-4023 | 2010-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154631372 | Heather Kidney | Behavioral Analyst | 69 Old Tuck Bog Road, Rochester, MA 02770 | 2010-10-21 |
| 1831177054 | Town of Rochester | Ambulance | 59 Hartley Rd, Rochester Fire Dept., Rochester, MA 02770 | 2006-01-06 |
| 1184056749 | Jessica T Viera | Behavioral Analyst | 9 Douglas Cor, Rochester, MA 02770-1010 | 2013-08-06 |
| 1972034114 | Debra Tolstonog | Counselor | 174 Neck Rd, Rochester, MA 02770-1306 | 2017-03-21 |
| 1972050680 | Nicole Pruchnik | Personal Emergency Response Attendant | 7 Bassett St, Rochester, MA 02770-1309 | 2016-09-10 |
| 1639118854 | John F Mueller | Family Medicine | 69 Snipatuit Rd, Rochester, MA 02770-1504 | 2006-06-05 |
| 1669952792 | Barbara Franconi Smith | Social Worker | 45 Cushman Rd, Rochester, MA 02770-1514 | 2018-08-17 |
| 1912098609 | Sandra Arlene Ciaffoni | Nurse Practitioner | 161 Cushman Rd, Rochester, MA 02770-1523 | 2006-09-27 |
| 1336269588 | Old Colony Regional Vocational Technical High School District | Local Education Agency (LEA) | 476 North Ave, Rochester, MA 02770-1811 | 2007-03-30 |
| 1912332784 | Caitlin Elizabeth Vandal | Social Worker | 476 North Ave, Rochester, MA 02770-1811 | 2013-09-11 |
| Find all providers in zip 02770 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104439728 | Andrea Brennan Licensed Mental Health Counseling, Pllc | Community/Behavioral Health | 245 Old Meadow Dr, Rochester, NY 14626-3548 | 2020-08-24 |
| 1407475270 | Southwood Psychiatric Hospital, LLC | Community/Behavioral Health | 203-205 Brighton Avenue, Rochester, PA 15074-2161 | 2020-04-13 |
| 1104338284 | Nicole Monta Psychotherapy, Plc | Community/Behavioral Health | 900 W University Dr, Rochester, MI 48307-1817 | 2017-10-30 |
| 1942722079 | Phoenix Psychology Services, Pllc | Community/Behavioral Health | 423 3rd Ave Se Ste 201, Rochester, MN 55904-4897 | 2017-07-11 |
| 1689102246 | Families & Friends of The Mentally Ill | Community/Behavioral Health | 320 N Goodman St, Rochester, NY 14607-1185 | 2017-05-26 |
| 1790221992 | Victory Fitness | Community/Behavioral Health | 52 Depew St, Rochester, NY 14611-2403 | 2017-01-11 |
| 1336681428 | Exercise Express LLC | Community/Behavioral Health | 232 Plymouth Ave S, Rochester, NY 14608-2237 | 2016-11-07 |
| 1457730160 | Maria Nichols | Community/Behavioral Health | 200 Frank Dimino Way Apt 203, Rochester, NY 14624-1188 | 2015-05-27 |
| 1043615586 | Amar Wellness Services, LLC | Community/Behavioral Health | 6556 Clarkia Dr Nw, Rochester, MN 55901-0285 | 2014-10-27 |
| 1639590045 | Riverstone Psychological Services | Community/Behavioral Health | 511 Northern Hills Dr Ne, Suite 2, Rochester, MN 55906 | 2014-01-02 |
| Find all providers in ROCHESTER | ||||
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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.