Provider Demographics
NPI:1902409972
Name:MINDS THAT MATTER COUNSELING PC
Entity Type:Organization
Organization Name:MINDS THAT MATTER COUNSELING PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUTER
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:641-355-6463
Mailing Address - Street 1:PO BOX 514
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50428-0514
Mailing Address - Country:US
Mailing Address - Phone:641-355-6463
Mailing Address - Fax:
Practice Address - Street 1:1524 US HIGHWAY 18 W
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE
Practice Address - State:IA
Practice Address - Zip Code:50428-1161
Practice Address - Country:US
Practice Address - Phone:641-355-6463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-20
Last Update Date:2022-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)