Cognivia Care LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

COGNIVIA CARE LLC

Practice address

903 Main St
Manchester, CT 06040-6008

Phone

(860) 854-4733

NPI assigned

Apr 8, 2025

Organization subpart

No

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

Authorized official

Name

Kerisha S Prince, PMHNPNPI 1861107591

Title

Owner

Phone

(718) 201-9840

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

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

• Kerisha S Prince

  • Psychiatric/Mental Health Nurse Practitioner
  • West Hartford, CT
  • NPI 1861107591
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1053105411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060406008",
            "telephone_number": "860-854-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGNIVIA CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-08",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "PRINCE",
        "authorized_official_first_name": "KERISHA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-201-9840",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brendan Coburn, RD
• Latanya Cockfield
• Christina Coelho
• Charles Coffie
• Christin Cofiell, LPC
• Cindy Cohen, RD
• Debra Cohn, PA
• Gina Colantoni
• Kevin Coleman, MS, LPC LADC
• Denise Williams Coley, PSY.D.

• Psychiatric/Mental Health Nurse Practitioner in Manchester, CT
• Providers in Manchester, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.