Provider Demographics
NPI:1952965881
Name:KATZ, CIPORA (LSW, ACSW)
Entity type:Individual
Prefix:
First Name:CIPORA
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:LSW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6722 BUSTLETON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-2341
Mailing Address - Country:US
Mailing Address - Phone:215-708-1645
Mailing Address - Fax:215-708-1650
Practice Address - Street 1:3103 HULMEVILLE RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-4381
Practice Address - Country:US
Practice Address - Phone:215-638-8600
Practice Address - Fax:215-638-3856
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW001744E104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASW001744EOtherPA LICENCE