Healthcare Provider Details

I. General information

NPI: 1962748814
Provider Name (Legal Business Name): SUMMER KATZ, LMHC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2012
Last Update Date: 02/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

452 OSCEOLA ST SUITE 113
ALTAMONTE SPRINGS FL
32701-7817
US

IV. Provider business mailing address

452 OSCEOLA ST SUITE 113
ALTAMONTE SPRINGS FL
32701-7817
US

V. Phone/Fax

Practice location:
  • Phone: 407-733-2110
  • Fax:
Mailing address:
  • Phone: 407-733-2110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH 11223
License Number StateFL

VIII. Authorized Official

Name: SUMMER KATZ
Title or Position: THERAPIST / OWNER
Credential: LMHC
Phone: 407-733-2110