Individual provider Active NPI

Alexis Taylor Cogley, RBT, QMHP-T

  • Behavior Technician
  • Roanoke, VA
National Provider Identifier
1619567146
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
1320 Plantation Rd NE
Roanoke, VA 24012-5713
Phone
(540) 266-7903
Fax
(866) 499-8840
NPI assigned
Jan 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Primary

Addresses

Primary practice location

1320 Plantation Rd NE
Roanoke, VA 24012-5713

Mailing address

1320 Plantation Rd NE
Roanoke, VA 24012-5713
Phone (540) 266-7903

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260402000827 VA Practitioner - Mental Health Counselor 9739664228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

301 Elm Ave SW
Roanoke, VA 24016-4001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Therapeutic Alliance LLC PastSince Jan 24, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1619567146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 PLANTATION RD NE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240125713",
            "telephone_number": "540-266-7903",
            "fax_number": "866-499-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 PLANTATION RD NE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240125713",
            "telephone_number": "540-266-7903",
            "fax_number": "866-499-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGLEY",
        "first_name": "ALEXIS",
        "middle_name": "TAYLOR",
        "name_prefix": "Mrs.",
        "credential": "RBT, QMHP-T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-19",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.