Organization Active NPI

Cognitive Care Support Services L.L.C.

  • Clinical Social Worker
  • Henderson, NV
National Provider Identifier
1538736103
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
COGNITIVE CARE SUPPORT SERVICES L.L.C.
Practice address
2831 Saint Rose Pkwy Ste 200
Henderson, NV 89052-4841
Phone
(405) 212-7348
NPI assigned
Jun 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Authorized official

Name
Deanna Beth Moslander, LCSW
Title
Owner
Phone
(405) 212-7348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

2831 Saint Rose Pkwy Ste 200
Henderson, NV 89052-4841

Mailing address

2831 Saint Rose Pkwy Ste 200
Henderson, NV 89052-4841
Phone (405) 212-7348

Other identifiers 1

IdentifierTypeStateIssuer
1376889378MedicaidNV

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623283200000",
    "number": "1538736103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 SAINT ROSE PKWY STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524841",
            "telephone_number": "405-212-7348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 SAINT ROSE PKWY STE 200",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524841",
            "telephone_number": "405-212-7348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COGNITIVE CARE SUPPORT SERVICES L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A",
        "authorized_official_last_name": "MOSLANDER",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-212-7348",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1376889378",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.