NPIMap

Organization Active NPI

Cognitive Development Center

  • Preferred Provider Organization
  • Monroe, LA
National Provider Identifier
1013466051
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
Legal business name
COGNITIVE DEVELOPMENT CENTER
Practice address
316 Woodale Dr Apt 11
Monroe, LA 71203-2712
Phone
(318) 600-6045
NPI assigned
Oct 3, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Authorized official

Name
Chellcy Jackson, M.S.
Title
MHP
Phone
(318) 418-0329

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X Primary

Addresses

Primary practice location

316 Woodale Dr Apt 11
Monroe, LA 71203-2712

Mailing address

316 Woodale Dr Apt 11
Monroe, LA 71203-2712
Phone (318) 600-6045

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1013466051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 WOODALE DR APT 11",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032712",
            "telephone_number": "318-600-6045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 WOODALE DR APT 11",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712032712",
            "telephone_number": "318-600-6045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGNITIVE DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "CHELLCY",
        "authorized_official_title_or_position": "MHP",
        "authorized_official_telephone_number": "318-418-0329",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.