| Cognitive Change, Llc | |
|
770 N Cotner Blvd Ste 328 Lincoln NE 68505-2344 | |
| (402) 286-2754 | |
| Not Available |
| Full Name | Cognitive Change, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 770 N Cotner Blvd Ste 328, Lincoln, Nebraska |
| Authorized Official Name and Position | Mary Kathyrn Ogle (OWNER) |
| Authorized Official Contact | 4022862754 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognitive Change, Llc 770 N Cotner Blvd Ste 328 Lincoln NE 68505-2344 Ph: (402) 286-2754 | Cognitive Change, Llc 770 N Cotner Blvd Ste 328 Lincoln NE 68505-2344 Ph: (402) 286-2754 |
| NPI Number | 1841789070 |
|---|---|
| Provider Enumeration Date | 05/03/2018 |
| Last Update Date | 05/03/2018 |
| Medicare PECOS PAC ID | 6204183726 |
|---|---|
| Medicare Enrollment ID | O20180716000881 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841789070 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mary Kathleen Ogle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639329477 PECOS PAC ID: 6002163532 Enrollment ID: I20180716002028 |
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