| Mindly Group, Pllc | |
|
8406 Six Forks Rd Suite 204 Raleigh NC 27615-3074 | |
| (919) 617-9656 | |
| (919) 617-9656 |
| Full Name | Mindly Group, Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 8406 Six Forks Rd, Raleigh, North Carolina |
| Authorized Official Name and Position | Stephanie Dawn Phillips (OWNER) |
| Authorized Official Contact | 9196179656 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindly Group, Pllc 8406 Six Forks Rd Suite 204 Raleigh NC 27615-3074 Ph: (919) 617-9656 | Mindly Group, Pllc 8406 Six Forks Rd Suite 204 Raleigh NC 27615-3074 Ph: (919) 617-9656 |
| NPI Number | 1306196944 |
|---|---|
| Provider Enumeration Date | 09/11/2012 |
| Last Update Date | 10/18/2022 |
| Certification Date | 10/18/2022 |
| Medicare PECOS PAC ID | 3072744028 |
|---|---|
| Medicare Enrollment ID | O20140317000413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306196944 | NPI | - | NPPES |
| 6008821 | Medicaid | NC |
| Provider Name | John N Von Der Lehr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962770487 PECOS PAC ID: 2466678404 Enrollment ID: I20151118002978 |
| Provider Name | Barbara Garrett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124213491 PECOS PAC ID: 7416237565 Enrollment ID: I20161206001868 |
| Provider Name | Sarah Renee Smusz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568890739 PECOS PAC ID: 4880976018 Enrollment ID: I20170124002170 |
| Provider Name | Michelle L Chachkes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750574844 PECOS PAC ID: 4385902196 Enrollment ID: I20171228001926 |
| Provider Name | Rebecca Anne Kyle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417566613 PECOS PAC ID: 1153746318 Enrollment ID: I20200805000101 |
| Provider Name | Brigitte Marie Zylaroch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902430804 PECOS PAC ID: 2466824370 Enrollment ID: I20230202000042 |
| Provider Name | Andrew Todd Lindsey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497041446 PECOS PAC ID: 5991154304 Enrollment ID: I20231211002971 |
| Provider Name | Connie Shelton Lancaster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144480922 PECOS PAC ID: 0941659874 Enrollment ID: I20231218001194 |
| Provider Name | Samantha Wathen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629426754 PECOS PAC ID: 8325499353 Enrollment ID: I20240104000059 |
| Provider Name | Stephanie Dawn Phillips |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225345689 PECOS PAC ID: 2163839093 Enrollment ID: I20240213002057 |
| Provider Name | Iyabosola Oluwafunmilola Ajani |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467974162 PECOS PAC ID: 5395181838 Enrollment ID: I20240307000363 |
| Provider Name | Stephanie Jordan Lucas |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275207862 PECOS PAC ID: 7315385929 Enrollment ID: I20240402001904 |
| Provider Name | Anna Bengtson Broadwell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295225373 PECOS PAC ID: 6901245273 Enrollment ID: I20240418004238 |
| Provider Name | Gregory Linares |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1548735053 PECOS PAC ID: 3375981186 Enrollment ID: I20240514003618 |
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