| Cognitive Wellness Llc | |
|
220 W Brandon Blvd Ste 203 Brandon FL 33511-5100 | |
| (813) 382-3377 | |
| (813) 381-3909 |
| Full Name | Cognitive Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 220 W Brandon Blvd Ste 203, Brandon, Florida |
| Authorized Official Name and Position | Jordon Hendrieth (PRESIDENT) |
| Authorized Official Contact | 8133823377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognitive Wellness Llc 220 W Brandon Blvd Ste 203 Brandon FL 33511-5100 Ph: (813) 382-3377 | Cognitive Wellness Llc 220 W Brandon Blvd Ste 203 Brandon FL 33511-5100 Ph: (813) 382-3377 |
| NPI Number | 1366951378 |
|---|---|
| Provider Enumeration Date | 09/21/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 5092074195 |
|---|---|
| Medicare Enrollment ID | O20180118000719 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366951378 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jordon J Hendrieth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538417407 PECOS PAC ID: 9436418530 Enrollment ID: I20180320003275 |
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