Healthcare Provider Details

I. General information

NPI: 1609763077
Provider Name (Legal Business Name): BRYAN SHURIGAR PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 CANAL ST
NEW ORLEANS LA
70112-3018
US

IV. Provider business mailing address

3443 ESPLANADE AVE APT 250
NEW ORLEANS LA
70119-2946
US

V. Phone/Fax

Practice location:
  • Phone: 504-702-3000
  • Fax:
Mailing address:
  • Phone: 308-520-7513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number1743PL
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: