Healthcare Provider Details

I. General information

NPI: 1376432914
Provider Name (Legal Business Name): MENDING PIECES THERAPY GROUP, LICENSED CLINICAL SOCIAL WORKER CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 CALIFORNIA AVE STE 125
BAKERSFIELD CA
93304-1364
US

IV. Provider business mailing address

4725 PANAMA LN STE D3-205
BAKERSFIELD CA
93313-3404
US

V. Phone/Fax

Practice location:
  • Phone: 661-444-2123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: LAUREN DEAN
Title or Position: CEO
Credential:
Phone: 661-343-8643