MEDICARE: COGNITIVE MINDS IN MOTION

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	:	1437024742
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COGNITIVE MINDS IN MOTION

Provider Business Mailing Address
First Line	:	43 RIVES RD STE F
Second Line	:
City	:	PETERSBURG
State	:	VA
Zip	:	23805-9427
Country	:	US
Telephone Number	:	571-455-9803
Fax Number	:

Provider Business Practice Location Address
First Line	:	3198 PARLIAMENT CIR STE 303
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-0001
Country	:	US
Telephone Number	:	571-455-9803
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TIRA JONES
Credential	:
Telephone Number	:	571-455-9803

Provider Enumeration Date	:	10/07/2025
Last Update Date	:	10/07/2025

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Directions to “COGNITIVE MINDS IN MOTION ” Practice Location

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