Healthcare Provider Details

I. General information

NPI: 1558287581
Provider Name (Legal Business Name): CARY KOGAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 PRYTANIA ST STE 611
NEW ORLEANS LA
70115-8104
US

IV. Provider business mailing address

180 FOURTH AVENUE
OTTAWA ONTARIO
K1S2L6
CA

V. Phone/Fax

Practice location:
  • Phone: 504-233-9006
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number351532
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: