Provider Demographics
NPI:1902433758
Name:COGNITIVE ASSESSMENT & REFERRAL SERVICES PLLC
Entity Type:Organization
Organization Name:COGNITIVE ASSESSMENT & REFERRAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIANNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GALLUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:602-515-7811
Mailing Address - Street 1:9502 N 47TH ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-5219
Mailing Address - Country:US
Mailing Address - Phone:602-515-7811
Mailing Address - Fax:
Practice Address - Street 1:1825 E NORTHERN AVE STE 161B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-3812
Practice Address - Country:US
Practice Address - Phone:480-865-5514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-23
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty