MEDICARE: MENDING HEARTS COUNSELING CENTER, 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1891480117
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENDING HEARTS COUNSELING CENTER, LLC

Provider Business Mailing Address
First Line	:	5639 WHITEFORD RD
Second Line	:
City	:	SYLVANIA
State	:	OH
Zip	:	43560-2527
Country	:	US
Telephone Number	:	419-458-3030
Fax Number	:	419-517-1084

Provider Business Practice Location Address
First Line	:	5639 WHITEFORD RD
Second Line	:
City	:	SYLVANIA
State	:	OH
Zip	:	43560-2527
Country	:	US
Telephone Number	:	419-458-3030
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER
Name	:	MRS. MARLENE MARIE DOLINAR
Credential	:	LPCC
Telephone Number	:	419-458-3030

Provider Enumeration Date	:	04/11/2023
Last Update Date	:	03/13/2026

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