Healthcare Provider Details

I. General information

NPI: 1093648230
Provider Name (Legal Business Name): EVOLVING MINDS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1271 S SUBER RD STE B
GREER SC
29650-0940
US

IV. Provider business mailing address

2106 OLD SPARTANBURG RD
GREER SC
29650-2763
US

V. Phone/Fax

Practice location:
  • Phone: 864-655-5845
  • Fax: 864-469-2040
Mailing address:
  • Phone: 864-244-0405
  • Fax: 864-469-2040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CANDANCE CODE
Title or Position: PARTNER/EXECUTIVE DIRECTOR
Credential: OTD, OTR/L
Phone: 662-719-9211