Provider Demographics
NPI:1750993218
Name:MINDS MATTER
Entity type:Organization
Organization Name:MINDS MATTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:GORBETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-370-2535
Mailing Address - Street 1:PO BOX 23432
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47724-1432
Mailing Address - Country:US
Mailing Address - Phone:812-449-5407
Mailing Address - Fax:
Practice Address - Street 1:2205 E MORGAN AVE STE 122
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-4358
Practice Address - Country:US
Practice Address - Phone:812-449-5407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health