Provider Demographics
NPI:1508530015
Name:MINDS TO MEND THERAPY PLLC
Entity Type:Organization
Organization Name:MINDS TO MEND THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:TRYSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZZOLA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-904-8945
Mailing Address - Street 1:909 MERCHANTS CT
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:NC
Mailing Address - Zip Code:27330-7439
Mailing Address - Country:US
Mailing Address - Phone:919-904-8945
Mailing Address - Fax:
Practice Address - Street 1:909 MERCHANTS CT
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27330-7439
Practice Address - Country:US
Practice Address - Phone:919-904-8945
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)