Healthcare Provider Details
I. General information
NPI: 1013849157
Provider Name (Legal Business Name): MINDS MATTER OF NORTH CAROLINA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8601 SIX FORKS RD S FORUM DRIVE SUITE 400
RALEIGH NC
27615
US
IV. Provider business mailing address
6701 W 64TH ST STE 125
OVERLAND PARK KS
66202-4007
US
V. Phone/Fax
- Phone: 913-789-9900
- Fax:
- Phone: 913-216-4120
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XN1300X |
| Taxonomy | Neurorehabilitation Occupational Therapist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251N0400X |
| Taxonomy | Neurology Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EMILY
K
HAUG
Title or Position: VICE PRESIDENT OF OPERATIONS
Credential:
Phone: 913-216-4120