MEDICARE: COGNITIVE RESTORATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	NONE	OTHER		NONE

General Provider Information

NPI Number	:	1093365207
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COGNITIVE RESTORATION LLC

Provider Business Mailing Address
First Line	:	100 W CENTRAL TEXAS EXPY STE 208
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-2080
Country	:	US
Telephone Number	:	254-432-5521
Fax Number	:	432-272-6227

Provider Business Practice Location Address
First Line	:	100 W CENTRAL TEXAS EXPY STE 208
Second Line	:
City	:	HARKER HEIGHTS
State	:	TX
Zip	:	76548-2080
Country	:	US
Telephone Number	:	254-432-5521
Fax Number	:	432-272-6227

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANIE SIGLER
Credential	:	LPC
Telephone Number	:	903-574-1246

Provider Enumeration Date	:	09/19/2019
Last Update Date	:	11/30/2025

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Directions to “COGNITIVE RESTORATION LLC ” Practice Location

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