Provider Demographics
NPI:1720316755
Name:COGNITIVE SOLUTIONS
Entity Type:Organization
Organization Name:COGNITIVE SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:202-903-4763
Mailing Address - Street 1:1025 THOMAS JEFFERSON ST. NW
Mailing Address - Street 2:SUITE 420 EAST
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007
Mailing Address - Country:US
Mailing Address - Phone:202-903-4763
Mailing Address - Fax:202-333-0366
Practice Address - Street 1:10400 EATON PL STE 225
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2210
Practice Address - Country:US
Practice Address - Phone:202-903-4763
Practice Address - Fax:202-333-0366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1000591103G00000X
261QM1300X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty