Organization Active NPI

Mind Over Matter Psychotherapeutics,PLLC

  • Psychiatry Physician
  • Fort Collins, CO
National Provider Identifier
1154086619
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MIND OVER MATTER PSYCHOTHERAPEUTICS,PLLC
Practice address
Mind Over Matter Psychotherapeutics,PLLC
608 E Harmony Rd # 302
Fort Collins, CO 80525
Phone
(307) 200-7383
NPI assigned
Nov 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Nauman Hanif Taj, MDNPI 1942516539
Title
Psychiatrist
Phone
(970) 616-2666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

Mind Over Matter Psychotherapeutics,PLLC
608 E Harmony Rd # 302
Fort Collins, CO 80525

Mailing address

Mind Over Matter Psychotherapeutics,PLLC
608 E Harmony Rd # 302
Fort Collins, CO 80525
Phone (307) 200-7383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211203000967 CO Part B Supplier - Clinic/Group Practice 7012307358 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Collins, CO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1635724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687996800000",
    "number": "1154086619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MIND OVER MATTER PSYCHOTHERAPEUTICS,PLLC",
            "address_2": "608 E HARMONY RD # 302",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80525",
            "telephone_number": "307-200-7383",
            "fax_number": "970-233-9219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MIND OVER MATTER PSYCHOTHERAPEUTICS,PLLC",
            "address_2": "608 E HARMONY RD # 302",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "80525",
            "telephone_number": "307-200-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND OVER MATTER PSYCHOTHERAPEUTICS,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-01",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A",
        "authorized_official_last_name": "TAJ",
        "authorized_official_first_name": "NAUMAN",
        "authorized_official_middle_name": "HANIF",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "970-616-2666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.