Provider Demographics
NPI:1548710809
Name:KOGAN, RANDEE (LMHC)
Entity type:Individual
Prefix:
First Name:RANDEE
Middle Name:
Last Name:KOGAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 LAKE WORTH RD STE 112
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3213
Mailing Address - Country:US
Mailing Address - Phone:561-600-7624
Mailing Address - Fax:
Practice Address - Street 1:5700 LAKE WORTH RD STE 112
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-3213
Practice Address - Country:US
Practice Address - Phone:561-600-7624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6168101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional