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Contact Information

WELLSOURCE
235 S EISENHOWER AVENUE
MASON CITY, IA50401
 Phone: 641-424-2075
 Fax: 641-424-9555
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Registered Nurse

163W00000X
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for WELLSOURCE

NPI Number 1992818249
LBN Legal business name WELLSOURCE
Authorized official ANDREW EASTWOOD - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/17/2006
Last updated 01/23/2015 - About 11 years ago
Identifiers
IA Medicaid 00065243
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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