Provider Demographics
NPI:1356000962
Name:MENTAL WEALTH SOLUTIONS, LLC
Entity type:Organization
Organization Name:MENTAL WEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:636-244-1769
Mailing Address - Street 1:3910 S OLD HIGHWAY 94 STE 121
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63304-2834
Mailing Address - Country:US
Mailing Address - Phone:636-244-1769
Mailing Address - Fax:
Practice Address - Street 1:3910 S OLD HIGHWAY 94 STE 121
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63304-2834
Practice Address - Country:US
Practice Address - Phone:636-244-1769
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty