Provider Demographics
NPI:1366734261
Name:MIND MATTERS RESEARCH LLC
Entity type:Organization
Organization Name:MIND MATTERS RESEARCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:WELTON
Authorized Official - Last Name:FREEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:907-868-7737
Mailing Address - Street 1:7926 PORT ORFORD DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-6023
Mailing Address - Country:US
Mailing Address - Phone:907-868-7737
Mailing Address - Fax:907-344-4537
Practice Address - Street 1:7926 PORT ORFORD DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-6023
Practice Address - Country:US
Practice Address - Phone:907-868-7737
Practice Address - Fax:907-344-4537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK519101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK519OtherAK LICENSE