MEDICARE: MIND OVER MATTER COUNSELING CENTER, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1467318436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIND OVER MATTER COUNSELING CENTER, PLLC

Provider Business Mailing Address
First Line	:	1239 73RD ST STE D
Second Line	:
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50324-1339
Country	:	US
Telephone Number	:	515-988-3799
Fax Number	:

Provider Business Practice Location Address
First Line	:	1239 73RD ST STE D
Second Line	:
City	:	WINDSOR HEIGHTS
State	:	IA
Zip	:	50324-1339
Country	:	US
Telephone Number	:	515-988-3799
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. NICHOLE MICHELLE MARTIN
Credential	:	LMHC
Telephone Number	:	515-988-3799

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	02/16/2026

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