Provider Demographics
NPI:1699406959
Name:KATZ, LAUREN (LCSW, LMT)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:LCSW, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5048 N WOLCOTT AVE APT 2N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-2669
Mailing Address - Country:US
Mailing Address - Phone:914-261-3619
Mailing Address - Fax:
Practice Address - Street 1:1821 W BELMONT AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-8496
Practice Address - Country:US
Practice Address - Phone:312-809-9585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-17
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL248.004776225700000X
IL149.0167711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical