MEDICARE: MINDFULLY MENDED PSYCHIATRY PLLC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1639052269
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDFULLY MENDED PSYCHIATRY PLLC

Provider Business Mailing Address
First Line	:	240 E RENFRO ST STE 203
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-3940
Country	:	US
Telephone Number	:	972-955-7474
Fax Number	:	972-955-2480

Provider Business Practice Location Address
First Line	:	240 E RENFRO ST STE 203
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-3940
Country	:	US
Telephone Number	:	972-955-7474
Fax Number	:	972-955-2480

Authorized Official
Title or Position	:	OWNER
Name	:	JESSICA STEHL
Credential	:	DNP, APRN, PMHNP-BC
Telephone Number	:	972-955-7474

Provider Enumeration Date	:	07/30/2025
Last Update Date	:	01/21/2026

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