CENTER FOR COGNITIVE REHABILITATION (NPI# 1003957879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003957879 |
| Entity Type | Organization |
| Organization Name | CENTER FOR COGNITIVE REHABILITATION |
| Practice Address |
1276 Mcconnell Dr Suite C Decatur GA 30033-3506 |
| Practice Telephone | 4043211441 |
| Practice Fax Number | 4043215876 |
| Mailing Telephone | 4043211441 |
| Mailing Fax Number | 4043215876 |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PAGE G. WARE (OFFICE MANAGER) |
| Authorized Official Telephone | 4043211441 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PSY000615 | GA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184703738 | Center for Cognitive Rehabilitation | Family Medicine | 403 River Rd, Fair Haven, NJ 07704 | 2006-11-03 |
| Street Address |
1276 MCCONNELL DR SUITE C |
| City | DECATUR |
| State | GA |
| Zip Code | 30033-3506 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881997468 | Alysa Gredel Wall | Clinical Neuropsychologist | 1276 Mcconnell Dr, Suite C, Decatur, GA 30033-3508 | 2010-12-21 |
| 1841525987 | Cognitive Rehabilitation of Georgia, PC | Psychologist | 1276 Mcconnell Dr, Suite C, Decatur, GA 30033-3508 | 2009-10-07 |
| 1386898344 | John Wayne Beasley | Chiropractor | 1276 Mcconnell Dr, Suite B, Decatur, GA 30033-3508 | 2008-11-04 |
| 1871741389 | Georgia Mua, LLC | Chiropractor | 1276 Mcconnell Dr, Ste. A&b, Decatur, GA 30033-3508 | 2008-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922613785 | Healing Minds, Helping Hearts, LLC | Social Worker | 2532 N Decatur Rd, Apt 1304, Decatur, GA 30033 | 2020-09-09 |
| 1700412517 | Delana Finney | Orthotist | Vamc - Atlanta, 1670 Clairmont Rd, Decatur, GA 30033 | 2020-03-13 |
| 1194389353 | Katherine Serafen | Physician Assistant | 2701 N Decatur Road, Ground Floor Suite 520, Decatur, GA 30033 | 2019-04-23 |
| 1194290973 | Suzanne Johnson | Psychologist | Atlanta Va Health Care System, 1670 Clairmont Rd, Decatur, GA 30033 | 2018-10-09 |
| 1245705334 | Mcleod Counseling Services, LLC | Clinic/Center | 2801 N. Decatur Rd, Suite 185, Decatur, GA 30033 | 2018-10-04 |
| 1225514797 | Erkin Mirkhatovich Turganov | Pharmacist | 2951 Cedar Brook Dr, Decatur, GA 30033 | 2018-07-17 |
| 1356834972 | Sharlencia Lord | Nurse Practitioner | 2738 N Decatur Rd # 292-3173, Decatur, GA 30033 | 2018-06-08 |
| 1194213140 | Zacarias Yanis Jr. | Clinical Neuropsychologist | 1276 Mcconnell Drive Ste C., Decatur, GA 30033 | 2018-04-25 |
| 1780181370 | Ryan Patton | Orthopaedic Surgery | 2723 Hollywood Dr, Decatur, GA 30033 | 2018-04-10 |
| 1437669751 | Sholanda D Hooper | Nurse Practitioner | 1601 Clairmont Rd, Decatur, GA 30033 | 2017-10-02 |
| Find all providers in zip 30033 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194213140 | Zacarias Yanis Jr. | Clinical Neuropsychologist | 1276 Mcconnell Drive Ste C., Decatur, GA 30033 | 2018-04-25 |
| 1316451719 | Zainab Delawalla | Clinical Neuropsychologist | 125 Clairemont Ave Ste 510, Decatur, GA 30030-2504 | 2017-11-21 |
| 1215326160 | Tristan Young | Clinical Neuropsychologist | 1276 Mcconnell Dr Ste C, Decatur, GA 30033-3506 | 2015-01-15 |
| 1376610261 | Pate & Culp Psychological Associates, L.L.C. | Clinical Neuropsychologist | 2450 Lawrenceville Hwy Ste 101, Decatur, GA 30033-3226 | 2006-11-29 |
| 1518991967 | Joseph T. Elder | Clinical Neuropsychologist | 1439 Mclendon Dr Ste D, Decatur, GA 30033-1841 | 2006-07-10 |
| 1821037953 | Patricia O'connell | Clinical Neuropsychologist | 2440 Lawrenceville Hwy, Suite 200, Decatur, GA 30033-3226 | 2006-06-05 |
| 1295229359 | Kristian Peter Nitsch | Clinical Neuropsychologist | 1942 Clairmont Rd, Decatur, GA 30033-3406 | 2018-06-21 |
| 1881149243 | Susan Shwartz | Clinical Neuropsychologist | 1942 Clairmont Rd, Decatur, GA 30033-3406 | 2016-08-16 |
| 1255703724 | Ekaterina Staikova | Clinical Neuropsychologist | 12 Executive Park Drive, Decatur, GA 30329-2206 | 2015-10-23 |
| 1710321229 | Center for Neurobehavioral Disorders, LLC | Clinical Neuropsychologist | 2490 N Water St, Suite 9, Decatur, IL 62526-4251 | 2013-04-26 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.