Healthcare Provider Details

I. General information

NPI: 1902664964
Provider Name (Legal Business Name): COGNITIVE ORGANICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2024
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 POPLAR ST NW
BOLIVAR OH
44612-9209
US

IV. Provider business mailing address

256 POPLAR ST NW
BOLIVAR OH
44612-9209
US

V. Phone/Fax

Practice location:
  • Phone: 614-610-1396
  • Fax:
Mailing address:
  • Phone: 614-610-1396
  • Fax: 330-821-1742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SARAH DOWNES
Title or Position: OWNER
Credential:
Phone: 330-302-1121