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General NPI Number Information
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NPI Number | 1023983509
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Entity Type | Organization
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Legal Business Name | MENDING MINDS PROFESSIONAL PSYCHOTHERAPY
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Dates
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Enumeration Date | 10/06/2025
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 200 ROSIE SQ
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City | WOOD RIDGE
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State | NJ
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Zip | 07075-7008
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Country | US
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Telephone | 646-653-5712
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Fax |
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Provider Business Mailing Address
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Address Line | 200 ROSIE SQ APT 4224
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City | WOOD RIDGE
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State | NJ
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Zip | 07075-7006
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Country | US
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Telephone | 646-653-5712
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Fax |
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Authorized Official
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Title or Position | OWNER/ PSYCHOTHERAPIST
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Name | MRS. MELISSA GONZALEZ
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Credential | LPC
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Telephone | 918-208-7129
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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