Provider Demographics
NPI:1790064145
Name:KATZ, JESSICA E (MS, LMHC, LCMHC, LPC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:E
Last Name:KATZ
Suffix:
Gender:F
Credentials:MS, LMHC, LCMHC, LPC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:E
Other - Last Name:THEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMHC
Mailing Address - Street 1:50 W BROADWAY, STE 333, PMB 357717
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84101-2070
Mailing Address - Country:US
Mailing Address - Phone:321-458-5663
Mailing Address - Fax:
Practice Address - Street 1:50 W BROADWAY, STE 333 PMB 357717
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84101-2070
Practice Address - Country:US
Practice Address - Phone:321-458-5663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2025-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13474101YM0800X
MNCC04990101YM0800X
UT11736106-6004101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health