Provider Demographics
NPI:1770630949
Name:KATZ, LYNDA JACQUELINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:JACQUELINE
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 1:3916 WESTCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27707-5067
Mailing Address - Country:US
Mailing Address - Phone:919-419-9399
Mailing Address - Fax:919-419-9399
Practice Address - Street 1:3916 WESTCHESTER RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-5067
Practice Address - Country:US
Practice Address - Phone:919-419-9399
Practice Address - Fax:919-419-9399
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH747103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30009727Medicaid
NH000168043Medicare PIN