Provider Demographics
NPI:1881267193
Name:MENTAL-EASE LLC
Entity type:Organization
Organization Name:MENTAL-EASE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:AAYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:484-951-7656
Mailing Address - Street 1:1742 CREEK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FOGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18051-1715
Mailing Address - Country:US
Mailing Address - Phone:484-951-7656
Mailing Address - Fax:
Practice Address - Street 1:1742 CREEK VIEW DR
Practice Address - Street 2:
Practice Address - City:FOGELSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18051-1715
Practice Address - Country:US
Practice Address - Phone:484-951-7656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA013058OtherLICENSE