Provider Demographics
NPI:1518971183
Name:KATZ, RITA D (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:D
Last Name:KATZ
Suffix:
Gender:F
Credentials:MSW LCSW
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 3022
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28406
Mailing Address - Country:US
Mailing Address - Phone:910-794-8210
Mailing Address - Fax:910-794-8212
Practice Address - Street 1:6303 OLEANDER DR
Practice Address - Street 2:CAPE FEAR COUNSELING & PSYCHOTHERAPY
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403
Practice Address - Country:US
Practice Address - Phone:910-794-8210
Practice Address - Fax:910-794-8212
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC000812103T00000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6002352Medicaid
2861870AMedicare ID - Type Unspecified