MEDICARE: MEND THE MIND LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	261QM0850X	Adult Mental Health Clinic/Center
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center
4	251S00000X	Community/Behavioral Health Agency
5	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
6	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1790511863
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEND THE MIND LLC

Provider Business Mailing Address
First Line	:	7510 LA SALETTE ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-6115
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 SOUTHWEST FWY STE 101
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77098-4520
Country	:	US
Telephone Number	:	713-569-8834
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LASHAUN BARNES
Credential	:
Telephone Number	:	601-618-7764

Provider Enumeration Date	:	09/13/2024
Last Update Date	:	01/09/2026

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Directions to “MEND THE MIND LLC ” Practice Location

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