| Mending Trauma LLC | |
|
801 N Lincoln Ave Monett MO 65708-1641 | |
| (479) 276-3021 | |
| Not Available |
| Full Name | Mending Trauma LLC |
|---|---|
| Speciality | Counselor |
| Location | 801 N Lincoln Ave, Monett, Missouri |
| Authorized Official Name and Position | Anthony Airoso (OFFICER) |
| Authorized Official Contact | 4792763021 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mending Trauma LLC 418 Euclid Ave Monett MO 65708-1926 Ph: (479) 276-3021 | Mending Trauma LLC 801 N Lincoln Ave Monett MO 65708-1641 Ph: (479) 276-3021 |
| NPI Number | 1326841578 |
|---|---|
| Provider Enumeration Date | 03/31/2025 |
| Last Update Date | 12/08/2025 |
| Certification Date | 12/08/2025 |
| Medicare PECOS PAC ID | 1759872195 |
|---|---|
| Medicare Enrollment ID | O20251113003996 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326841578 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Leina Hoyt |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1225154230 PECOS PAC ID: 5395236731 Enrollment ID: I20251117003059 |
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