Provider Demographics
NPI:1285135558
Name:BETH KATZ LCSW-C, LLC
Entity type:Organization
Organization Name:BETH KATZ LCSW-C, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:M
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:410-371-2728
Mailing Address - Street 1:1205 YORK RD STE 21
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6211
Mailing Address - Country:US
Mailing Address - Phone:410-371-2728
Mailing Address - Fax:
Practice Address - Street 1:1205 YORK RD STE 21
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-6211
Practice Address - Country:US
Practice Address - Phone:410-371-2728
Practice Address - Fax:410-296-7631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-22
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
MD10248261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5200504001Medicaid
MD145019101Medicaid
MDCB91OtherBLUE CROSS BLUE SHIELD ID NUMBER
MD160798OtherBEACON HEALTH OPTIONS ID NUMBER