Provider Demographics
NPI:1508739442
Name:MENDING MINDS LLC
Entity type:Organization
Organization Name:MENDING MINDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NELSON
Authorized Official - Middle Name:EDGAR
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:914-925-5289
Mailing Address - Street 1:8 VAN TER
Mailing Address - Street 2:
Mailing Address - City:SPARKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10976-1406
Mailing Address - Country:US
Mailing Address - Phone:845-589-2222
Mailing Address - Fax:845-589-2222
Practice Address - Street 1:8 VAN TER
Practice Address - Street 2:
Practice Address - City:SPARKILL
Practice Address - State:NY
Practice Address - Zip Code:10976-1406
Practice Address - Country:US
Practice Address - Phone:845-589-2222
Practice Address - Fax:845-589-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty