MEDICARE: DR. KAREN PELLERIN PELLERIN PSY.D.

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
1	103TC0700X	Clinical Psychologist	822	LA

General Provider Information

NPI Number	:	1043241896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN PELLERIN PELLERIN PSY.D.

Provider Business Mailing Address
First Line	:	201 SAINT CHARLES AVENUE, STE 114-724
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70170-0114
Country	:	US
Telephone Number	:	504-221-2428
Fax Number	:	504-221-2431

Provider Business Practice Location Address
First Line	:	201 SAINT CHARLES AVENUE, STE 114-724
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70170-0114
Country	:	US
Telephone Number	:	504-221-2428
Fax Number	:	504-221-2431

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	08/20/2025

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