Organization Active NPI

Cognitive Dissonance Inc

  • Clinical Social Worker
  • Davie, FL
National Provider Identifier
1518033323
Registry record updated Mar 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW89 Issued in FL
Legal business name
COGNITIVE DISSONANCE INC
Practice address
4800 SW 64TH Ave
Suite 105-D
Davie, FL 33314-4429
Phone
(954) 981-3200
Fax
(423) 790-1620
NPI assigned
Nov 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2008

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

Authorized official

Name
Dr. Renee F Mason, PHD
Title
President
Phone
(954) 981-3200

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X SW89 FL Primary
Marriage & Family TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 106H00000X MT58 FL

Addresses

Primary practice location

4800 SW 64TH Ave
Suite 105-D
Davie, FL 33314-4429

Mailing address

5324 Hayes Street
Hollywood, FL 33021
Phone (954) 981-3200

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204675200000",
    "number": "1518033323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5324 HAYES STREET",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "33021",
            "telephone_number": "954-981-3200",
            "fax_number": "423-790-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SW 64TH AVE",
            "address_2": "SUITE 105-D",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333144429",
            "telephone_number": "954-981-3200",
            "fax_number": "423-790-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGNITIVE DISSONANCE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2008-03-05",
        "status": "A",
        "authorized_official_last_name": "MASON",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-981-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW89",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT58",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2008; 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.