Healthcare Provider Details

I. General information

NPI: 1770463853
Provider Name (Legal Business Name): REBECCA KATZ MA, NCSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8908 RIGGS RD
ADELPHI MD
20783-1632
US

IV. Provider business mailing address

6300 RED CEDAR PL UNIT 308
BALTIMORE MD
21209-5412
US

V. Phone/Fax

Practice location:
  • Phone: 301-408-6860
  • Fax:
Mailing address:
  • Phone: 301-408-6860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number1001665089
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: