Organization
MINDLY GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE DAWN PHILLIPS LCMHCS (OWNER)
(919) 617-9656
Entity
Organization
Contact information
Practice address
8406 SIX FORKS RD, SUITE 204, RALEIGH, NC 27615-3074
(919) 617-9656
(919) 617-9656
Mailing address
8406 SIX FORKS RD, SUITE 204, RALEIGH, NC 27615-3074
(919) 617-9656
(919) 617-9656
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8809
NC
1041C0700X
Clinical Social Worker
C007721
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6008821
—
NC
Enumeration date
09/11/2012
Last updated
10/18/2022
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