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General NPI Number Information
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NPI Number | 1992255434
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Entity Type | Organization
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Legal Business Name | MENDING MINDS BEHAVIORAL HEALTH, PLLC
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Dates
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Enumeration Date | 10/08/2016
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 1766 METROMEDICAL DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3861
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Country | US
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Telephone | 910-426-6363
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Fax | 910-426-6364
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Provider Business Mailing Address
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Address Line | 1766 METROMEDICAL DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3861
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Country | US
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Telephone | 910-426-6363
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Fax | 910-426-6364
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Authorized Official
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Title or Position | OWNER
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Name | CASEY J SCOTT
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Credential | APRN,PMHNP-BC,FNP-C
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Telephone | 910-973-3407
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 5006507
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License Number State | NC
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