Provider Demographics
NPI:1831906114
Name:COGNITIVE CONNECTIONS KY
Entity type:Organization
Organization Name:COGNITIVE CONNECTIONS KY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YAHSHANAH
Authorized Official - Middle Name:YEHOSHEBAH
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-625-5080
Mailing Address - Street 1:6601 DIXIE HIGHWAY
Mailing Address - Street 2:SUITE 4 BOX 193
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40258
Mailing Address - Country:US
Mailing Address - Phone:502-625-5080
Mailing Address - Fax:
Practice Address - Street 1:6707 FENSKE LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40258-4607
Practice Address - Country:US
Practice Address - Phone:859-421-6938
Practice Address - Fax:502-305-6649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty