MEDICARE: COGNITIVE HEALTH SOLUTIONS 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1639035546
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COGNITIVE HEALTH SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	5448 MILLENIA LAKES BLVD APT 7203
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-3466
Country	:	US
Telephone Number	:	904-993-1320
Fax Number	:

Provider Business Practice Location Address
First Line	:	5448 MILLENIA LAKES BLVD APT 7203
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-3466
Country	:	US
Telephone Number	:	904-993-1320
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ANTONIA MEJIA
Credential	:	LCSW
Telephone Number	:	904-993-1320

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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