Provider Demographics
NPI:1457692105
Name:MENDING HEARTS FAMILY COUNSELING
Entity Type:Organization
Organization Name:MENDING HEARTS FAMILY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANITA
Authorized Official - Middle Name:S
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:609-234-8050
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:609-234-8050
Mailing Address - Fax:609-499-0685
Practice Address - Street 1:60 CATHY LN
Practice Address - Street 2:SUITE 101
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-9727
Practice Address - Country:US
Practice Address - Phone:609-234-8050
Practice Address - Fax:609-499-0685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37F100173700251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health