Provider Demographics
NPI:1790065043
Name:KATZ COUNSELING AND EDUCATIONAL PSYCHOLOGY
Entity Type:Organization
Organization Name:KATZ COUNSELING AND EDUCATIONAL PSYCHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NOLAN
Authorized Official - Middle Name:HEYWOOD
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:239-247-1756
Mailing Address - Street 1:12641 WORLD PLAZA LANE
Mailing Address - Street 2:BLDG #56
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-3990
Mailing Address - Country:US
Mailing Address - Phone:239-247-1756
Mailing Address - Fax:239-690-2438
Practice Address - Street 1:12641 WORLD PLAZA LANE
Practice Address - Street 2:BLDG #56
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3990
Practice Address - Country:US
Practice Address - Phone:239-247-1756
Practice Address - Fax:239-690-2438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-18
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty