MEDICARE: MINDS MATTER OF NORTH CAROLINA LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	106S00000X	Behavior Technician
3	171M00000X	Case Manager/Care Coordinator
4	225XN1300X	Neurorehabilitation Occupational Therapist
5	235Z00000X	Speech-Language Pathologist
6	261QP2000X	Physical Therapy Clinic/Center
7	2251N0400X	Neurology Physical Therapist

General Provider Information

NPI Number	:	1013849157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MINDS MATTER OF NORTH CAROLINA LLC

Provider Business Mailing Address
First Line	:	6701 W 64TH ST STE 125
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66202-4007
Country	:	US
Telephone Number	:	913-216-4120
Fax Number	:

Provider Business Practice Location Address
First Line	:	8601 SIX FORKS RD
Second Line	:	S FORUM DRIVE SUITE 400
City	:	RALEIGH
State	:	NC
Zip	:	27615
Country	:	US
Telephone Number	:	913-789-9900
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT OF OPERATIONS
Name	:	EMILY K HAUG
Credential	:
Telephone Number	:	913-216-4120

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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