Provider Demographics
NPI:1194421651
Name:SPRINGWELL, LLC
Entity type:Organization
Organization Name:SPRINGWELL, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:EARLE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCAS, CCS
Authorized Official - Phone:919-591-4193
Mailing Address - Street 1:901 S HARDING DR APT B
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-7424
Mailing Address - Country:US
Mailing Address - Phone:919-591-4193
Mailing Address - Fax:
Practice Address - Street 1:901 S HARDING DR APT B
Practice Address - Street 2:
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-7424
Practice Address - Country:US
Practice Address - Phone:919-591-4193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty