SNJ Cognitive Health, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

8006-123 Issued in WI

Legal business name

SNJ COGNITIVE HEALTH, LLC

Practice address

W241N5972 Goldencrest CT
Sussex, WI 53089-3687

Phone

(414) 406-5598

NPI assigned

Apr 15, 2016

Organization subpart

No

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

Authorized official

Name

Sara O'Hara, LCSW

Title

Social Worker

Phone

(414) 406-5598

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460678400000",
    "number": "1326492349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W241N5972 GOLDENCREST CT",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530893687",
            "telephone_number": "414-406-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W241N5972 GOLDENCREST CT",
            "city": "SUSSEX",
            "state": "WI",
            "postal_code": "530893687",
            "telephone_number": "414-406-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNJ COGNITIVE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2016-04-15",
        "status": "A",
        "authorized_official_last_name": "O'HARA",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "414-406-5598",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "WI",
            "license": "8006-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.