Provider Demographics
NPI:1902477896
Name:MENTAL CLEANSE THERAPEUTIC & CONSULTING SERVICES LLC
Entity Type:Organization
Organization Name:MENTAL CLEANSE THERAPEUTIC & CONSULTING SERVICES LLC
Other - Org Name:MENTAL CLEANSE THERAPEUTIC & COUNSELING SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:COURTNI
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:513-213-0056
Mailing Address - Street 1:2692 MADISON RD STE N1
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1320
Mailing Address - Country:US
Mailing Address - Phone:513-213-0056
Mailing Address - Fax:
Practice Address - Street 1:430 READING RD STE 300
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45202-1460
Practice Address - Country:US
Practice Address - Phone:513-213-0056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty