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NPI Code Detail

MEDICARE: COGNASTICS, PLLC

MEDICARE: COGNASTICS, PLLC
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
1101YM0800XMental Health Counselor
2251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1871117614
Entity Type Code : Organization
Provider Name (Legal Business Name) : COGNASTICS, PLLC
Provider Business Mailing Address
First Line : 3980 PREMIER DR STE 110
Second Line :
City : HIGH POINT
State : NC
Zip : 27265-8409
Country : US
Telephone Number : 336-662-2055
Fax Number : 844-444-0546
Provider Business Practice Location Address
First Line : 3980 PREMIER DR STE 110
Second Line :
City : HIGH POINT
State : NC
Zip : 27265-8409
Country : US
Telephone Number : 336-750-6028
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MS. SHAPEL BYNUM
Credential : LCMHC
Telephone Number : 336-662-2055
Provider Enumeration Date : 06/07/2020
Last Update Date : 11/03/2022

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Practice Location Address:
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27265-8409
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1316966419 — MR. ROBERT SCOTT JORDAN LCSW
Practice Location Address:
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1144751710 — MRS. JACLYN MICHELLE KELLER LCSW
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Practice Location Address:
3980 PREMIER DR STE 110
HIGH POINT, NC
27265-8409
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Practice Fax: 844-444-0546
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Practice Location Address:
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1265103956 — HINES HEALTH AND WELLNESS PLLC
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