Provider Demographics
NPI:1386310100
Name:MINDS ON THE MEND LLC
Entity type:Organization
Organization Name:MINDS ON THE MEND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DOMENICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZZA
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:401-237-2325
Mailing Address - Street 1:4 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:MEDWAY
Mailing Address - State:MA
Mailing Address - Zip Code:02053-1623
Mailing Address - Country:US
Mailing Address - Phone:401-237-2325
Mailing Address - Fax:
Practice Address - Street 1:4 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-1623
Practice Address - Country:US
Practice Address - Phone:401-237-2325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-20
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty