Organization
COGNITIVE CARE NETWORK, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE JACOBS LCSW (OWNER/CLINICIAN)
(480) 703-5905
Entity
Organization
Contact information
Practice address
3994 E AQUARIUS PL, CHANDLER, AZ 85249-5896
(480) 703-5905
(480) 703-5905
Mailing address
3994 E AQUARIUS PL, CHANDLER, AZ 85249-5896
(480) 703-5905
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861608861
INDIVIDUAL NPI NUMBER
AZ
Enumeration date
01/24/2018
Last updated
01/24/2018
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