WELLSPRING COUNSELING CENTER OF SOUTHERN OREGON, LLC (NPI# 1780894840) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780894840 |
| Entity Type | Organization |
| Organization Name | WELLSPRING COUNSELING CENTER OF SOUTHERN OREGON, LLC |
| Practice Address |
18 Portland Ave. Medford OR 97504-7309 |
| Practice Telephone | 5418570873 |
| Practice Fax Number | 5412451530 |
| Mailing Telephone | 5418570873 |
| Mailing Fax Number | 5412451530 |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2015-02-03 |
| Authorized Official Name | MR. BERNIE LEGNER (OWNER) |
| Authorized Official Telephone | 5418570873 |
| Authorized Official Credential | ED.D., LMFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | WELLSPRING COUNSELING CENTER OF SOUTHERN OREGON, LLC | 18 Portland Ave, Medford, OR 97504 |
| Street Address |
18 PORTLAND AVE. |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-7309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114223302 | Marika P Mooyman | Marriage & Family Therapist | 1005 E Main St Bldg B, Medford, OR 97504-7448 | 2011-02-04 |
| 1891099842 | John Joseph Johnson | Marriage & Family Therapist | 107 E Main St Ste 29, Medford, OR 97501 | 2011-01-05 |
| 1326274192 | Tara Michelle Hurley | Marriage & Family Therapist | 11 Sagamore Ave, Medford, MA 02155-2107 | 2009-06-06 |
| 1013143403 | Dwight Henry Horch | Marriage & Family Therapist | 9 Holly Dr, Medford, NJ 08055-8810 | 2009-05-31 |
| 1336326826 | Patricia M. Brady-ciarcia | Marriage & Family Therapist | 16 Bradlee Rd, Third Floor, Medford, MA 02155-3111 | 2008-01-28 |
| 1417168121 | Gabriel Joel Mccoy | Marriage & Family Therapist | 1316 W Main St, Medford, OR 97501-2937 | 2007-05-24 |
| 1831309301 | James Sidney Stumbo | Marriage & Family Therapist | 3550 National Dr, Medford, OR 97504-4148 | 2007-05-23 |
| 1518173640 | Sallyann Roth | Marriage & Family Therapist | 137 Brooks St, Medford, MA 02155-2243 | 2007-05-15 |
| 1356467492 | Nicole Christine Ryan | Marriage & Family Therapist | 328 S Central Ave Ste 205, Medford, OR 97501-7274 | 2007-03-21 |
| 1932223021 | Barbara Jean Parsons | Marriage & Family Therapist | 201 W Main St Ste 3c, Medford, OR 97501-2744 | 2007-03-16 |
| Find all providers in MEDFORD | ||||
Please comment or provide details below to improve the information on WELLSPRING COUNSELING CENTER OF SOUTHERN OREGON, LLC.
| 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.