Provider Demographics
NPI:1154197721
Name:MIND ON THE MEND LLC
Entity type:Organization
Organization Name:MIND ON THE MEND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:MARQUISS
Authorized Official - Suffix:
Authorized Official - Credentials:MSSA, LCSW
Authorized Official - Phone:307-258-0716
Mailing Address - Street 1:701 ANTLER DR STE 206
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82601-1749
Mailing Address - Country:US
Mailing Address - Phone:307-439-5588
Mailing Address - Fax:
Practice Address - Street 1:701 ANTLER DR STE 206
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82601-1749
Practice Address - Country:US
Practice Address - Phone:307-439-5588
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-27
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty