| The Mending Room Counseling Center For Wellness | |
|
4300 N University Dr # A153 Lauderhill FL 33351-6249 | |
| (954) 787-8702 | |
| (754) 732-7441 |
| Full Name | The Mending Room Counseling Center For Wellness |
|---|---|
| Speciality | Social Worker |
| Location | 4300 N University Dr # A153, Lauderhill, Florida |
| Authorized Official Name and Position | Jessica Oladumiye (OWNER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 9547878702 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Mending Room Counseling Center For Wellness 4300 N University Dr # A153 Lauderhill FL 33351-6249 Ph: (816) 204-7632 | The Mending Room Counseling Center For Wellness 4300 N University Dr # A153 Lauderhill FL 33351-6249 Ph: (954) 787-8702 |
| NPI Number | 1437885720 |
|---|---|
| Provider Enumeration Date | 07/28/2022 |
| Last Update Date | 09/21/2022 |
| Certification Date | 09/21/2022 |
| Medicare PECOS PAC ID | 2264801539 |
|---|---|
| Medicare Enrollment ID | O20221208000004 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437885720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica Oladumiye |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013649458 PECOS PAC ID: 5092195081 Enrollment ID: I20220708000400 |
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