Organization Active NPI

CNS Memory Clinic LLC

  • Clinical Neuropsychologist
  • Goodyear, AZ
National Provider Identifier
1881087369
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
3656 Issued in AZ
Legal business name
CNS MEMORY CLINIC LLC
Practice address
2440 N Litchfield Rd Ste 200
Goodyear, AZ 85395-1664
Phone
(623) 977-6860
Fax
(623) 977-2016
NPI assigned
Mar 9, 2015
Last updated
Feb 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Authorized official

Name
Dr. Dane A Higgins, PHDNPI 1023089034
Title
Owner
Phone
(623) 977-6860

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 3656 AZ Primary
Psychologist 103T00000X 3656 AZ

Addresses

Primary practice location

2440 N Litchfield Rd Ste 200
Goodyear, AZ 85395-1664

Mailing address

2440 N Litchfield Rd Ste 200
Goodyear, AZ 85395-1664
Phone (623) 977-6860

Other practice location 1

2440 N Litchfield Rd Ste 208
Goodyear, AZ 85395-1664
Phone (623) 977-6860

Other practice location 2

2440 N Litchfield Rd Ste 210
Goodyear, AZ 85395-1664
Phone (623) 977-6860

Other identifiers 1

IdentifierTypeStateIssuer
874322MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170829001014 AZ Part B Supplier - Clinic/Group Practice 2961775895 Receives reassigned benefits from 5 practitioners
Practice locations: Goodyear, AZ

National Provider Directory

National Provider Directory

Locations

2440 N Litchfield Rd
Ste 200
Goodyear, AZ 85395
Phone (623) 977-6860

2440 N Litchfield Rd
Ste 208
Goodyear, AZ 85395
Phone (623) 977-6860

2440 N Litchfield Rd
Ste 210
Goodyear, AZ 85395
Phone (623) 440-5053

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1425859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769990400000",
    "number": "1881087369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2440 N LITCHFIELD RD STE 200",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951664",
            "telephone_number": "623-977-6860",
            "fax_number": "623-977-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2440 N LITCHFIELD RD STE 200",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853951664",
            "telephone_number": "623-977-6860",
            "fax_number": "623-977-2016"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2440 N Litchfield Rd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853951664",
            "country_code": "US",
            "telephone_number": "623-977-6860",
            "fax_number": "623-977-2016",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2440 N Litchfield Rd Ste 210",
            "address_purpose": "LOCATION",
            "city": "Goodyear",
            "state": "AZ",
            "postal_code": "853951664",
            "country_code": "US",
            "telephone_number": "623-977-6860",
            "fax_number": "623-977-2016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CNS MEMORY CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-09",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A",
        "authorized_official_last_name": "HIGGINS",
        "authorized_official_first_name": "DANE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "623-977-6860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "AZ",
            "license": "3656",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AZ",
            "license": "3656",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "874322",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Goodyear, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.