Provider Demographics
NPI:1063951523
Name:COGNITIVE EVALUATION SERVICES, PLLC
Entity type:Organization
Organization Name:COGNITIVE EVALUATION SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARYBETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILAR-HEATH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:919-249-8121
Mailing Address - Street 1:1101 PEMBERTON HILL RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502-0089
Mailing Address - Country:US
Mailing Address - Phone:919-249-8121
Mailing Address - Fax:
Practice Address - Street 1:1101 PEMBERTON HILL RD
Practice Address - Street 2:SUITE 202
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27502-0089
Practice Address - Country:US
Practice Address - Phone:919-249-8121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty