NPIMap

Organization Active NPI

Cognitive Consults and Technology LLC

  • Clinical Neuropsychologist
  • Fairfax, VA
National Provider Identifier
1003330408
Registry record updated Jul 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
0810004396 Issued in VA
Legal business name
COGNITIVE CONSULTS AND TECHNOLOGY LLC
Practice address
3020 Hamaker Court, Suite 103
Neuropsychology Associates of Fairfax
Fairfax, VA 22031
Phone
(703) 876-0966
Fax
(703) 876-1628
NPI assigned
Jul 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Robert L Kane, PH.D.NPI 1295826592
Title
Ceo
Phone
(410) 808-4667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X 0810004396 VA Primary

Addresses

Primary practice location

3020 Hamaker Court, Suite 103
Neuropsychology Associates of Fairfax
Fairfax, VA 22031

Mailing address

3604 Whitehaven Pkwy NW
Washington, DC 20007
Phone (410) 808-4667

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1501200000000",
    "number": "1003330408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 WHITEHAVEN PKWY NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20007",
            "telephone_number": "410-808-4667",
            "fax_number": "202-621-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 HAMAKER COURT, SUITE 103",
            "address_2": "NEUROPSYCHOLOGY ASSOCIATES OF FAIRFAX",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "22031",
            "telephone_number": "703-876-0966",
            "fax_number": "703-876-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGNITIVE CONSULTS AND TECHNOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-28",
        "last_updated": "2017-07-28",
        "status": "A",
        "authorized_official_last_name": "KANE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-808-4667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "VA",
            "license": "0810004396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.