Provider Demographics
NPI:1770279556
Name:MENDING MINDS COUNSELING PLLC
Entity type:Organization
Organization Name:MENDING MINDS COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, LCPC, MLADC
Authorized Official - Phone:978-846-7144
Mailing Address - Street 1:1 MIDDLE ST STE 235
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4484
Mailing Address - Country:US
Mailing Address - Phone:978-846-7144
Mailing Address - Fax:
Practice Address - Street 1:1 MIDDLE ST STE 235
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4484
Practice Address - Country:US
Practice Address - Phone:978-846-7144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty