Mending Space Therapy LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

MENDING SPACE THERAPY LLC

Practice address

501 Washington LN Ste 304
Jenkintown, PA 19046-3148

Phone

(215) 960-9843

NPI assigned

Sep 18, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tiffany R Hall, LMFT

Title

Owner/Therapist

Phone

(215) 960-9843

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568764800000",
    "number": "1265082614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON LN STE 304",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463148",
            "telephone_number": "215-960-9843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 WASHINGTON LN STE 304",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463148",
            "telephone_number": "215-960-9843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDING SPACE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-18",
        "last_updated": "2019-09-18",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "215-960-9843",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ann Mertens, M.AC., L.AC.
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• Jessica Middleton, RN
• Amy Miklos, RD

• Adult Mental Health Clinic/Center in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Adult Mental Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.