MEDICARE: THE MENTAL HEALTH EXPERIENCE, 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1891653184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MENTAL HEALTH EXPERIENCE, LLC

Provider Business Mailing Address
First Line	:	3464 WOODRIDGE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-1532
Country	:	US
Telephone Number	:	440-941-2941
Fax Number	:

Provider Business Practice Location Address
First Line	:	3464 WOODRIDGE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44121-1532
Country	:	US
Telephone Number	:	440-941-2941
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	NISHA GILMORE
Credential	:	LISW, CDCA
Telephone Number	:	440-941-2941

Provider Enumeration Date	:	01/14/2026
Last Update Date	:	01/14/2026

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Directions to “THE MENTAL HEALTH EXPERIENCE, LLC ” Practice Location

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