Provider Demographics
NPI:1508306358
Name:MENDING SOULS COUNSELING, LLC
Entity Type:Organization
Organization Name:MENDING SOULS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MAROTTO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:860-952-4005
Mailing Address - Street 1:87 CHURCH ST STE 112
Mailing Address - Street 2:
Mailing Address - City:EAST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06108-3742
Mailing Address - Country:US
Mailing Address - Phone:860-952-4005
Mailing Address - Fax:
Practice Address - Street 1:87 CHURCH ST STE 112
Practice Address - Street 2:
Practice Address - City:EAST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06108-3742
Practice Address - Country:US
Practice Address - Phone:860-952-4005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001838106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty