Provider Demographics
NPI:1629769872
Name:MENDING MINDS COUNSELING, PLLC
Entity Type:Organization
Organization Name:MENDING MINDS COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:TRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:361-522-4710
Mailing Address - Street 1:989 SANTA CRUZ LN
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-4485
Mailing Address - Country:US
Mailing Address - Phone:361-522-4710
Mailing Address - Fax:
Practice Address - Street 1:5030 HOLLY RD STE A
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4759
Practice Address - Country:US
Practice Address - Phone:361-434-0421
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty