Provider Demographics
NPI:1497977540
Name:KATZ, LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LOUISE
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
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:PO BOX 2181
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37024-2181
Mailing Address - Country:US
Mailing Address - Phone:615-377-8588
Mailing Address - Fax:615-370-5917
Practice Address - Street 1:117 28TH AVENUE NORTH
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1411
Practice Address - Country:US
Practice Address - Phone:615-377-8588
Practice Address - Fax:615-370-5917
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP2304103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3981771Medicaid
TN3981771Medicaid