Organization
UNTETHERED THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FAIMMIAH MENYONGAI LCSW (OWNER)
(872) 216-5273
Entity
Organization
Contact information
Practice address
10769 BROADWAY, PMB 208, CROWN POINT, IN 46307-7316
(872) 216-5273
Mailing address
10769 BROADWAY, PMB 208, CROWN POINT, IN 46307
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/24/2025
Last updated
07/24/2025
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