Provider Demographics
NPI:1447606397
Name:DR. JEFFREY S. KATZ, PHD, PC
Entity Type:Organization
Organization Name:DR. JEFFREY S. KATZ, PHD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:SCHWARTZ
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-463-4232
Mailing Address - Street 1:2940 N LYNNHAVEN RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-6949
Mailing Address - Country:US
Mailing Address - Phone:757-343-7036
Mailing Address - Fax:
Practice Address - Street 1:2940 N LYNNHAVEN RD
Practice Address - Street 2:SUITE 110
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-6949
Practice Address - Country:US
Practice Address - Phone:757-343-7036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-10
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001549103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty