Healthcare Provider Details

I. General information

NPI: 1124959853
Provider Name (Legal Business Name): MENDING MINDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4405 N HOLLAND SYLVANIA RD STE 102
TOLEDO OH
43623-3533
US

IV. Provider business mailing address

4405 N HOLLAND SYLVANIA RD STE 102
TOLEDO OH
43623-3533
US

V. Phone/Fax

Practice location:
  • Phone: 567-777-2808
  • Fax:
Mailing address:
  • Phone: 567-777-2808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: JENNELL BROWN
Title or Position: THERAPIST
Credential: LPCC
Phone: 517-331-0366