Provider Demographics
NPI:1053509612
Name:KELLOGG, SCOTT (PHD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:KELLOGG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 WEST 44TH STREET
Mailing Address - Street 2:COGNITIVE THERAPY CENTER OF NEW YORK, SUITE 1007
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10036
Mailing Address - Country:US
Mailing Address - Phone:212-221-1818
Mailing Address - Fax:212-221-1818
Practice Address - Street 1:36 W 44TH ST
Practice Address - Street 2:SUITE 1007
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-8102
Practice Address - Country:US
Practice Address - Phone:212-221-1818
Practice Address - Fax:212-221-1818
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013067103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist