Provider Demographics
NPI:1659097848
Name:MENDING MIND THERAPY INC
Entity Type:Organization
Organization Name:MENDING MIND THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CMHC
Authorized Official - Phone:435-559-3620
Mailing Address - Street 1:PO BOX 1842
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-1842
Mailing Address - Country:US
Mailing Address - Phone:435-559-3620
Mailing Address - Fax:
Practice Address - Street 1:88 E FIDDLERS CANYON RD
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-9495
Practice Address - Country:US
Practice Address - Phone:435-559-3620
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-18
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty