Provider Demographics
NPI:1841525987
Name:COGNITIVE REHABILITATION OF GEORGIA, PC
Entity type:Organization
Organization Name:COGNITIVE REHABILITATION OF GEORGIA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL NEUROPSYCHOLOGIS
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SASS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-929-9009
Mailing Address - Street 1:2296 HENDERSON MILL ROAD NE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345
Mailing Address - Country:US
Mailing Address - Phone:404-929-9009
Mailing Address - Fax:404-929-9005
Practice Address - Street 1:2296 HENDERSON MILL ROAD NE
Practice Address - Street 2:SUITE 305
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345
Practice Address - Country:US
Practice Address - Phone:404-929-9009
Practice Address - Fax:404-929-9005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA00220379103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty