Provider Demographics
NPI:1801375209
Name:COGNITIVE BEHAVIORAL CARE INCORPORATED
Entity Type:Organization
Organization Name:COGNITIVE BEHAVIORAL CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JENKINS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:630-464-7990
Mailing Address - Street 1:525 DUNHAM RD STE 55
Mailing Address - Street 2:
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-1490
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:630-429-9419
Practice Address - Street 1:525 DUNHAM RD STE 55
Practice Address - Street 2:
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-1490
Practice Address - Country:US
Practice Address - Phone:630-464-7990
Practice Address - Fax:630-429-9419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071008363103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty