Provider Demographics
NPI:1275080277
Name:COGNITIVE CHANGE, LLC
Entity Type:Organization
Organization Name:COGNITIVE CHANGE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:STRADER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:973-845-8430
Mailing Address - Street 1:248 COLUMBIA TPKE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1210
Mailing Address - Country:US
Mailing Address - Phone:973-845-8430
Mailing Address - Fax:
Practice Address - Street 1:248 COLUMBIA TPKE BLDG 2
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1210
Practice Address - Country:US
Practice Address - Phone:973-845-8430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-07
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053352001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty