NPIMap

Organization Active NPI

Mind Redo

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wauseon, OH
National Provider Identifier
1497386148
Registry record updated Jan 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MIND REDO
Practice address
7320 State Route 108 Ste a
Wauseon, OH 43567-9244
Phone
(419) 285-6655
NPI assigned
Jan 31, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2020

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

Authorized official

Name
Sondra L Metts, LPCCNPI 1790294619
Title
Program Director
Phone
(419) 285-6655

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

7320 State Route 108 Ste a
Wauseon, OH 43567-9244

Mailing address

7320 State Route 108 Ste a
Wauseon, OH 43567-9244
Phone (419) 285-6655

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Contact@MindRedo.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210205000656 OH Part B Supplier - Clinic/Group Practice 8123432937 Receives reassigned benefits from 10 practitioners
Practice locations: Wauseon, OH

National Provider Directory

National Provider Directory

Locations

7320 State Route 108
Ste A
Wauseon, OH 43567
Phone (419) 285-6655

Interoperability endpoints

  • Direct secure messaging: contact@mindredo.com

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1580428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580428800000",
    "number": "1497386148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 STATE ROUTE 108 STE A",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435679244",
            "telephone_number": "419-285-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 STATE ROUTE 108 STE A",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435679244",
            "telephone_number": "419-285-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND REDO",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-31",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A",
        "authorized_official_last_name": "METTS",
        "authorized_official_first_name": "SONDRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "419-285-6655",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Contact@MindRedo.com",
            "affiliation": "N",
            "endpointDescription": "Business Email which is HIPAA compliant per BAA.",
            "address_1": "7320 State Route 108 Ste A",
            "city": "Wauseon",
            "state": "OH",
            "country_code": "US",
            "postal_code": "435679244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wauseon, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.