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WELLSPRING
NPI 1003851411
Counselor - Mental Health in Springfield, OH

Active since June 19, 2006
101 N FOUNTAIN AVE, SPRINGFIELD, OH 45502(937) 325-5564(937) 325-5564 Get Directions Write a Review

NPPES record last updated: December 16, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 16, 2024, Jun 15, 2023 (2 updates tracked since 2023).

About Wellspring NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WELLSPRING (NPI 1003851411), doing business as Family Service Agency, is a healthcare organization registered as a mental health in Springfield, Ohio and active in the NPI registry since June 2006. The organization maintains a secondary practice location in Urbana and lists Tiffany Nelson, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1003851411
Entity TypeOrganization
Primary Taxonomy101YM0800X
Legal Business NameWELLSPRING
Location Address101 N FOUNTAIN AVESpringfield, OH 45502-1118
Mailing Address101 N Fountain AveSpringfield, OH 45502-1118 · (937) 325-5564 · Fax (937) 325-5564
Phone(937) 325-5564
Fax(937) 325-5564
Organization SubpartNo
Authorized OfficialTiffany NelsonOffice Manager · (937) 325-5564
Enumeration DateJune 19, 2006
Last NPPES UpdateDecember 16, 20242 updates tracked since enumeration
NPPES CertifiedDecember 16, 2024
✔ NPI 1003851411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in OH · 0284
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 0284 (OH)
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
Also ListedMarriage & Family TherapistTaxonomy 106H00000X · License 0284 (OH)
101 N FOUNTAIN AVE, Springfield, OH 45502
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Other Names 1

Former Legal Business NameFamily Service Agency

Secondary Practice Location 1

Location 1906 Scioto StUrbana, OH 43078-2226 · Phone (937) 325-5564 · Fax (937) 325-5564

Other Identifiers 1

Medicaid10501OH

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Wellspring is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Wellspring, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tracey Stute, LISW-S
Clinical Social Worker
NPI 1447372602
15 E PLEASANT ST
Springfield, OH 45506
(937) 325-5564
✔ PECOS0.5 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wellspring's NPI number?

The NPI number for Wellspring is 1003851411. It was assigned to this organization in the NPPES registry on June 19, 2006. The provider was formerly known as Family Service Agency.

Where is Wellspring located?

Wellspring is located at 101 N Fountain Ave, Springfield, OH 45502. The listed phone number is (937) 325-5564.

What is Wellspring's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Wellspring enrolled in Medicare?

Yes. Wellspring is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Wellspring?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Wellspring. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Wellspring accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and Antidote Health Plan of Ohio, Inc. and 3 other insurers list Wellspring as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Wellspring was last updated on December 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.