Provider Demographics
NPI:1598234650
Name:COGNITIVE CONNECTIONS COUNSELING
Entity Type:Organization
Organization Name:COGNITIVE CONNECTIONS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:RECORE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-859-0095
Mailing Address - Street 1:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:FISKDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01518-0525
Mailing Address - Country:US
Mailing Address - Phone:508-347-7787
Mailing Address - Fax:508-347-7347
Practice Address - Street 1:559 MAIN ST STE 303A
Practice Address - Street 2:
Practice Address - City:FISKDALE
Practice Address - State:MA
Practice Address - Zip Code:01518-1208
Practice Address - Country:US
Practice Address - Phone:508-347-7787
Practice Address - Fax:508-347-7347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty