Center for Cognitive Rehabilitation

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PSY000615 Issued in GA

Legal business name

CENTER FOR COGNITIVE REHABILITATION

Practice address

1276 McConnell Dr
Suite C
Decatur, GA 30033-3506

Phone

(404) 321-1441

Fax

(404) 321-5876

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Page G. Ware

Title

Office Manager

Phone

(404) 321-1441

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003957879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 MCCONNELL DR",
            "address_2": "SUITE C",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333506",
            "telephone_number": "404-321-1441",
            "fax_number": "404-321-5876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 MCCONNELL DR",
            "address_2": "SUITE C",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300333506",
            "telephone_number": "404-321-1441",
            "fax_number": "404-321-5876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR COGNITIVE REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARE",
        "authorized_official_first_name": "PAGE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "404-321-1441"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "GA",
            "license": "PSY000615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rosa Denise Cedeno, LPC
• Ryan Daniel Cedermark, NP DC
• Diana Magaly Cedillo, CNM, MSN
• Center for Attachment Resource and Enrichment, Inc.
• Center for Behavioral Change PC
• Centerwell Senior Primary Care Ga PC
• Cep America LLC
• Cerebrofit LLC
• Myrna Cervetti, NCC
• Carolyn Ceto- Koumandarakis, LCSW

• Clinical Neuropsychologist in Decatur, GA
• Providers in Decatur, GA by specialty
• Clinical Neuropsychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.