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General NPI Number Information
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NPI Number | 1457692105
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Entity Type | Organization
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Legal Business Name | MENDING HEARTS FAMILY COUNSELING
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Dates
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Enumeration Date | 03/05/2013
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Last Update Date | 03/05/2013
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Provider Practice Location Address
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Address Line | 60 CATHY LN SUITE 101
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City | BURLINGTON
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State | NJ
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Zip | 08016-9727
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Country | US
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Telephone | 609-234-8050
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Fax | 609-499-0685
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | COLUMBUS
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State | NJ
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Zip | 08022-0130
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Country | US
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Telephone | 609-234-8050
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Fax | 609-499-0685
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MRS. DANITA S THOMPSON
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Credential | LMFT
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Telephone | 609-234-8050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 37F100173700
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License Number State | NJ
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