Provider Demographics
NPI:1689303851
Name:COGNIFIT LLC
Entity Type:Organization
Organization Name:COGNIFIT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:KIRSTEN
Authorized Official - Last Name:CALTA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-514-3706
Mailing Address - Street 1:19010 COUR ESTS
Mailing Address - Street 2:
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33558-2857
Mailing Address - Country:US
Mailing Address - Phone:813-514-3706
Mailing Address - Fax:
Practice Address - Street 1:19010 COUR ESTS
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33558-2857
Practice Address - Country:US
Practice Address - Phone:813-514-3706
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty