Provider Demographics
NPI:1518625581
Name:NEUROCOGNITIVE SOLUTIONS LLC
Entity Type:Organization
Organization Name:NEUROCOGNITIVE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AUST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-877-0161
Mailing Address - Street 1:7210 MANATEE AVE W # 1023
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-3439
Mailing Address - Country:US
Mailing Address - Phone:947-877-0161
Mailing Address - Fax:
Practice Address - Street 1:12360 66TH ST STE 930
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-3434
Practice Address - Country:US
Practice Address - Phone:941-877-0161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-07
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)