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
5500 NORRIS STREET, FORT WORTH, TX 76119
(817) 447-3001
Mailing address
PO BOX 446, LAKEWOOD, NJ 08701-0446
(732) 927-7080
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
08/30/2021
Last updated
11/03/2023
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