Organization Active NPI

Mind Above Matter LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Keller, TX
National Provider Identifier
1790239648
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
MIND ABOVE MATTER LLC
Practice address
250 College Ave
Keller, TX 76248-3449
Phone
(817) 447-3001
NPI assigned
Aug 9, 2016
Organization subpart
Yes
Parent organization
MIND ABOVE MATTER LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Authorized official

Name
Jeff Isaac
Title
Controller
Phone
(732) 927-7080

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Case Management Agency 251B00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

250 College Ave
Keller, TX 76248-3449

Mailing address

PO Box 446
Lakewood, NJ 08701-0446

Other names 1

  • MAM KISD Other name

National Provider Directory

National Provider Directory
Tax ID family
Ips Irving22 organizations share this tax ID, including this one
Part of
Ips Irving

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

Locations

250 College Ave
Keller, TX 76248

NPI Registry JSON

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698969600000",
    "number": "1790239648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 446",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087010446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 COLLEGE AVE",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483449",
            "telephone_number": "817-447-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND ABOVE MATTER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIND ABOVE MATTER LLC",
        "enumeration_date": "2016-08-09",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A",
        "authorized_official_last_name": "ISAAC",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "732-927-7080"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MAM KISD",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MAM KISD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.