Provider Demographics
NPI:1528867082
Name:KATZ, DAVID JAY (LSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JAY
Last Name:KATZ
Suffix:
Gender:M
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17318 BLUE WALK ST
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-2541
Mailing Address - Country:US
Mailing Address - Phone:732-299-4977
Mailing Address - Fax:
Practice Address - Street 1:169 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-2573
Practice Address - Country:US
Practice Address - Phone:732-299-4977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL054860001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical