MEDICARE: MENDING HEARTS & MINDS, LLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1376493528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENDING HEARTS & MINDS, LLC

Provider Business Mailing Address
First Line	:	6865 DEERPATH RD STE 101
Second Line	:
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6255
Country	:	US
Telephone Number	:	301-388-5069
Fax Number	:

Provider Business Practice Location Address
First Line	:	6865 DEERPATH RD STE 101
Second Line	:
City	:	ELKRIDGE
State	:	MD
Zip	:	21075-6255
Country	:	US
Telephone Number	:	301-388-5069
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST/OWNER
Name	:	PATRINA ANN ANDERSON
Credential	:	LCSW-C, LICSW
Telephone Number	:	301-388-5069

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	01/29/2026

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