OrganizationMindly Group, PllcCommunity/Behavioral HealthAgenciesPractice Address8406 Six Forks Rd, Suite 204, Raleigh, NC 27615-3074(919) 617-9656PECOS EnrollmentBased on the most recent information from CMS, provider Mindly Group, Pllc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1306196944Provider TypeOrganizationFull NameMindly Group, PllcSubpartNoEnumeration Date9/11/2012Last Updated10/18/2022Contact InformationPractice LocationPractice Address8406 Six Forks Rd, Suite 204, Raleigh, NC 27615-3074Phone(919) 617-9656Fax(919) 617-9656Mailing LocationMailing Address8406 Six Forks Rd, Suite 204, Raleigh, NC 27615-3074Phone(919) 617-9656Fax(919) 617-9656Authorized OfficialNamePhillips, Stephanie Dawn (Owner)Phone(919) 617-9656Provider TaxonomiesCodeDescriptionLicenseCode251S00000XPrimaryDescriptionCommunity/Behavioral HealthAgenciesLicenseUnlisted IssuerCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicense8809North CarolinaCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseC007721North CarolinaProvider IdentifiersIDDescriptionIssuerID6008821DescriptionMedicaidIssuerUnlistedNorth Carolina