Integrative Center for Cognitive Disorders PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY7360 Issued in FL

Legal business name

INTEGRATIVE CENTER FOR COGNITIVE DISORDERS PA

Practice address

6100 Hollywood Blvd
Suite 202
Hollywood, FL 33024-7900

Phone

(954) 894-4802

NPI assigned

Dec 7, 2011

Organization subpart

No

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

Authorized official

Name

Sara Malagold, PSYD

Title

Owner

Phone

(954) 894-4802

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1437427366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3160 NE 210TH ST",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331803634",
            "telephone_number": "954-894-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6100 HOLLYWOOD BLVD",
            "address_2": "SUITE 202",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330247900",
            "telephone_number": "954-894-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE CENTER FOR COGNITIVE DISORDERS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-07",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "MALAGOLD",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-894-4802",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY7360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.