Provider Demographics
NPI:1619632189
Name:CENTER FOR ADVANCE COGNITIVE STUDIES LLC
Entity Type:Organization
Organization Name:CENTER FOR ADVANCE COGNITIVE STUDIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ASTRID
Authorized Official - Middle Name:N
Authorized Official - Last Name:GANDARILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MSCP, LPC
Authorized Official - Phone:787-533-3996
Mailing Address - Street 1:F1 CALLE 13
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00959-4829
Mailing Address - Country:US
Mailing Address - Phone:787-533-3996
Mailing Address - Fax:
Practice Address - Street 1:VILLA CONTESSA
Practice Address - Street 2:EE10 CALLE MARGINAL
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-533-3996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-01
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty