Provider Demographics
NPI:1942039219
Name:COGNICARE NEUROPSYCHOLOGY SPECIALISTS
Entity type:Organization
Organization Name:COGNICARE NEUROPSYCHOLOGY SPECIALISTS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NEUROPSYCOLOGIST/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:
Authorized Official - Last Name:DECKARD
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:772-985-8394
Mailing Address - Street 1:850 NW US HIGHWAY1 STE 170
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-1019
Mailing Address - Country:US
Mailing Address - Phone:772-485-7331
Mailing Address - Fax:561-921-8790
Practice Address - Street 1:850 NW US HIGHWAY1 STE 170
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-1019
Practice Address - Country:US
Practice Address - Phone:772-485-7331
Practice Address - Fax:561-921-8790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty