Provider Demographics
NPI:1003376005
Name:MENDING PIECES, LLC
Entity Type:Organization
Organization Name:MENDING PIECES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-584-5650
Mailing Address - Street 1:2770 INDIAN RIVER BLVD STE 401C
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-4299
Mailing Address - Country:US
Mailing Address - Phone:772-584-5650
Mailing Address - Fax:
Practice Address - Street 1:601 21ST ST STE 300
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-0860
Practice Address - Country:US
Practice Address - Phone:772-584-5650
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-25
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty