Provider Demographics
NPI:1316912553
Name:KATZ, PATRICIA J (LCSW PA)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:J
Last Name:KATZ
Suffix:
Gender:F
Credentials:LCSW PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:762 HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-4539
Mailing Address - Country:US
Mailing Address - Phone:954-801-8174
Mailing Address - Fax:954-217-8547
Practice Address - Street 1:10031 PINES BLVD
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-6180
Practice Address - Country:US
Practice Address - Phone:954-801-8174
Practice Address - Fax:954-217-8547
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW60071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8879Medicare ID - Type UnspecifiedGROUP IDENTIFICATION #