OrganizationActive
Mentality PLLC
NPI 1629963855 · Community/Behavioral Health Agency · Fairview, TX
Provider details
- NPI number
- 1629963855
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Krystal Nicodemus, Owner(214) 702-1840
Specialties & taxonomies
Agencies
- Counselor101Y00000X
Behavioral Health & Social Service Providers
Practice location
163 Town Pl # 26
Fairview, TX 75069-1821
Phone: (214) 702-1840
Approximate (ZIP-level) locationGet directions
Mailing address
163 Town Pl # 26
Fairview, TX 75069-1821
Registry dates
- Enumerated
- 2025-06-10
- Last updated
- 2025-06-10
- Certified
- 2025-06-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.