Provider Demographics
NPI:1609585645
Name:MENDING HEARTS FAMILY COUNSELING
Entity Type:Organization
Organization Name:MENDING HEARTS FAMILY COUNSELING
Other - Org Name:MENDING HEARTS BEHAVIORAL HEALTH & FAMILY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANITA
Authorized Official - Middle Name:SHARICE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:609-499-0165
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NJ
Mailing Address - Zip Code:08022-0130
Mailing Address - Country:US
Mailing Address - Phone:609-499-0165
Mailing Address - Fax:
Practice Address - Street 1:60 CATHY LN STE 103
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-9727
Practice Address - Country:US
Practice Address - Phone:609-499-0165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENDING HEARTS FAMILY COUNSELING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-17
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)