Healthcare Provider Details

I. General information

NPI: 1023986593
Provider Name (Legal Business Name): MENTE SANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 E BROAD ST STE 112
COLUMBUS OH
43205-1378
US

IV. Provider business mailing address

1015 E BROAD ST STE 112
COLUMBUS OH
43205-1378
US

V. Phone/Fax

Practice location:
  • Phone: 614-285-6562
  • Fax:
Mailing address:
  • Phone: 614-285-6562
  • Fax: 608-387-8005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SARAH M FORTIN
Title or Position: PSYCHIATRIC NURSE PRACTITIONER/OWNE
Credential: MS, APRN, PMHNP-BC
Phone: 614-285-6562