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Organization
MIND ABOVE MATTER LLC
Active
Organization
MIND ABOVE MATTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF ISAAC (CONTROLLER)
(732) 927-7080
Entity
Organization
Contact information
Practice address
1000 N HIGHWAY 77, WAXAHACHIE, TX 75165-1754
(817) 482-0414
Mailing address
475 OBERLIN AVE S STE 203, LAKEWOOD, NJ 08701-7024
(817) 482-0414
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
06/21/2023
Last updated
11/03/2023
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