Provider Demographics
NPI:1073219440
Name:COGNITIVE HYGIENE
Entity Type:Organization
Organization Name:COGNITIVE HYGIENE
Other - Org Name:COGNITIVE HYGIENE ADVANCED THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GODDARD
Authorized Official - Suffix:
Authorized Official - Credentials:QMHS
Authorized Official - Phone:937-742-7101
Mailing Address - Street 1:8555 N DIXIE DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45414-2463
Mailing Address - Country:US
Mailing Address - Phone:937-742-7101
Mailing Address - Fax:
Practice Address - Street 1:8555 N DIXIE DR UNIT B
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45414-2463
Practice Address - Country:US
Practice Address - Phone:937-280-4415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-06
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health