Provider Demographics
NPI:1346794716
Name:KATHERINE MAZZA PSYCHOTHERAPY
Entity Type:Organization
Organization Name:KATHERINE MAZZA PSYCHOTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAZZA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:212-560-2264
Mailing Address - Street 1:309 E 49TH ST
Mailing Address - Street 2:APT 8C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-1634
Mailing Address - Country:US
Mailing Address - Phone:212-560-2264
Mailing Address - Fax:
Practice Address - Street 1:122 W 27TH ST
Practice Address - Street 2:10TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6227
Practice Address - Country:US
Practice Address - Phone:212-560-2264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004397101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty