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General NPI Number Information
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NPI Number | 1326749995
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Entity Type | Organization
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Legal Business Name | MIND WHAT MATTERS PSYCHOTHERAPY, PLLC
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 5149 BUSTED ROCK TRL
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City | RALEIGH
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State | NC
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Zip | 27610-2586
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Country | US
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Telephone | 919-200-0663
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 N ROGERS LN STE 121
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City | RALEIGH
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State | NC
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Zip | 27610-6083
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/OWNER
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Name | VIVIAN HURLSTON GONZALEZ
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Credential | LCSW, LCASA
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Telephone | 919-200-0663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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