Provider Demographics
NPI:1841739059
Name:DR. EMILY KATZ PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:DR. EMILY KATZ PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:404-368-1166
Mailing Address - Street 1:1201 CLAIRMONT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1258
Mailing Address - Country:US
Mailing Address - Phone:404-368-1166
Mailing Address - Fax:
Practice Address - Street 1:1201 CLAIRMONT RD STE 100
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1258
Practice Address - Country:US
Practice Address - Phone:404-368-1166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003647261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)