| Minds On The Mend Llc | |
| 
					4 Lincoln St Medway MA 02053-1623  | |
| (401) 237-2325 | |
| Not Available | 
| Full Name | Minds On The Mend Llc | 
|---|---|
| Speciality | Counselor | 
| Location | 4 Lincoln St, Medway, Massachusetts | 
| Authorized Official Name and Position | Domenica Rizza (CLINICAL PSYCHOTHERAPIST) | 
| Authorized Official Contact | 4012372325 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Minds On The Mend Llc 4 Lincoln St Medway MA 02053-1623 Ph: (401) 237-2325  | Minds On The Mend Llc 4 Lincoln St Medway MA 02053-1623 Ph: (401) 237-2325  | 
| NPI Number | 1386310100 | 
|---|---|
| Provider Enumeration Date | 08/20/2021 | 
| Last Update Date | 12/02/2021 | 
| Certification Date | 12/02/2021 | 
| Medicare PECOS PAC ID | 3072903277 | 
|---|---|
| Medicare Enrollment ID | O20211202000504 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1386310100 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary | 
| Provider Name | Domenica Rizza | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1568024206 PECOS PAC ID: 4981039138 Enrollment ID: I20200115002166  | 
| Provider Name | Kathryn Blair Brewer | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1114498904 PECOS PAC ID: 0244678373 Enrollment ID: I20240506000434  | 
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