MEDICARE: PAMELA ANN KAATZ MSW, LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801094622	MI

General Provider Information

NPI Number	:	1053752550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA ANN KAATZ MSW, LMSW

Provider Business Mailing Address
First Line	:	36400 WOODWARD AVE
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48304-0911
Country	:	US
Telephone Number	:	248-629-2799
Fax Number	:

Provider Business Practice Location Address
First Line	:	1685 BALDWIN AVE STE 100
Second Line	:
City	:	PONTIAC
State	:	MI
Zip	:	48340-1242
Country	:	US
Telephone Number	:	248-706-3450
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2013
Last Update Date	:	12/12/2024

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