Provider Demographics
NPI:1588111652
Name:WELLSPRINGS PSYCHOLOGICAL RESOURCES
Entity type:Organization
Organization Name:WELLSPRINGS PSYCHOLOGICAL RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:OXLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:706-246-0733
Mailing Address - Street 1:PO BOX 157
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30639-0157
Mailing Address - Country:US
Mailing Address - Phone:706-246-0733
Mailing Address - Fax:706-246-0722
Practice Address - Street 1:63 SPRINGS STATION DRIVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30639-0157
Practice Address - Country:US
Practice Address - Phone:808-268-1320
Practice Address - Fax:706-246-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0058341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty