MEDICARE: MENDED BEHAVIORAL & MENTAL HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1124687132
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENDED BEHAVIORAL & MENTAL HEALTH SERVICES

Provider Business Mailing Address
First Line	:	6407 BARDSTOWN RD # 257
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40291-3040
Country	:	US
Telephone Number	:	502-407-7890
Fax Number	:

Provider Business Practice Location Address
First Line	:	4229 BARDSTOWN RD STE 320
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40218-3275
Country	:	US
Telephone Number	:	502-883-0027
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	WASHEENER BARBER
Credential	:	LPCC-S
Telephone Number	:	502-407-7890

Provider Enumeration Date	:	06/12/2019
Last Update Date	:	05/12/2026

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