=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346006319
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MENTIA HEALTH AND WELLNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2024
-----------------------------------------------------
Last Update Date | 03/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 440 COBIA DR STE 102
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77494-6891
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-303-1440
-----------------------------------------------------
Fax | 346-426-8124
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 440 COBIA DR STE 102
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77494-6891
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-303-1440
-----------------------------------------------------
Fax | 346-426-8124
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ PROVIDER
-----------------------------------------------------
Name | FOLASADE R AKINKUOWO
-----------------------------------------------------
Credential | PMHNP-BC
-----------------------------------------------------
Telephone | 832-303-1440
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------