Provider Demographics
NPI:1710604475
Name:GENTLE MIND MENTAL HEALTH
Entity Type:Organization
Organization Name:GENTLE MIND MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEKHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-702-5548
Mailing Address - Street 1:5267 WARNER AVE # 117
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92649-4079
Mailing Address - Country:US
Mailing Address - Phone:714-702-5548
Mailing Address - Fax:
Practice Address - Street 1:19712 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-2407
Practice Address - Country:US
Practice Address - Phone:714-702-5548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty