Healthcare Provider Details

I. General information

NPI: 1356277230
Provider Name (Legal Business Name): COGNIZANT COUNSELING & NEUROFEEDBACK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43458 N MURPHY AVE
SAN TAN VALLEY AZ
85140-9822
US

IV. Provider business mailing address

43458 N MURPHY AVE
SAN TAN VALLEY AZ
85140-9822
US

V. Phone/Fax

Practice location:
  • Phone: 480-788-9676
  • Fax:
Mailing address:
  • Phone: 480-788-9676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: ASHLEY LYNCH GAEDE
Title or Position: OWNER
Credential: LPC
Phone: 480-788-9676