| Cognizant Psychological Services Pllc | |
|
51 Sherwood Ter Ste W Lake Bluff IL 60044-2232 | |
| (224) 424-3087 | |
| Not Available |
| Full Name | Cognizant Psychological Services Pllc |
|---|---|
| Speciality | Psychologist |
| Location | 51 Sherwood Ter Ste W, Lake Bluff, Illinois |
| Authorized Official Name and Position | Carolina M Garcia-leahy (OWNER AND CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2244243087 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognizant Psychological Services Pllc 507 Quassey Ave Lake Bluff IL 60044-1601 Ph: (312) 399-5027 | Cognizant Psychological Services Pllc 51 Sherwood Ter Ste W Lake Bluff IL 60044-2232 Ph: (224) 424-3087 |
| NPI Number | 1750882239 |
|---|---|
| Provider Enumeration Date | 02/21/2018 |
| Last Update Date | 09/03/2024 |
| Certification Date | 09/03/2024 |
| Medicare PECOS PAC ID | 0749533032 |
|---|---|
| Medicare Enrollment ID | O20181103000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750882239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 071.006516 (Illinois) | Secondary |
| 103TC0700X | Psychologist - Clinical | 071.008275 (Illinois) | Primary |
| Provider Name | Brian J Leahy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679505358 PECOS PAC ID: 6103728043 Enrollment ID: I20040122000369 |
| Provider Name | Carolina M Garcia-leahy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861762734 PECOS PAC ID: 4385895119 Enrollment ID: I20121103000032 |
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