| Cognitive Rehabilitation Of Georgia, Pc | |
|
1276 Mcconnell Dr Suite C Decatur GA 30033-3508 | |
| (404) 929-9009 | |
| (404) 929-9005 |
| Full Name | Cognitive Rehabilitation Of Georgia, Pc |
|---|---|
| Speciality | Psychologist |
| Location | 1276 Mcconnell Dr, Decatur, Georgia |
| Authorized Official Name and Position | John R Sass (OWNER/PRESIDENT) |
| Authorized Official Contact | 4049299009 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognitive Rehabilitation Of Georgia, Pc 1276 Mcconnell Dr Suite C Decatur GA 30033-3508 Ph: (404) 929-9009 | Cognitive Rehabilitation Of Georgia, Pc 1276 Mcconnell Dr Suite C Decatur GA 30033-3508 Ph: (404) 929-9009 |
| NPI Number | 1841525987 |
|---|---|
| Provider Enumeration Date | 10/07/2009 |
| Last Update Date | 10/07/2009 |
| Medicare PECOS PAC ID | 8224161567 |
|---|---|
| Medicare Enrollment ID | O20100806000244 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841525987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 00220379 (Georgia) | Primary |
| Provider Name | John R Sass |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093858854 PECOS PAC ID: 8224087895 Enrollment ID: I20050120000879 |
| Provider Name | Zachary C Bayer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619296555 PECOS PAC ID: 6305163163 Enrollment ID: I20150317000093 |
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