Healthcare Provider Details

I. General information

NPI: 1285135558
Provider Name (Legal Business Name): BETH KATZ LCSW-C, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 03/25/2022
Certification Date: 03/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 YORK RD STE 21
TIMONIUM MD
21093-6211
US

IV. Provider business mailing address

1205 YORK RD STE 21
TIMONIUM MD
21093-6211
US

V. Phone/Fax

Practice location:
  • Phone: 410-371-2728
  • Fax: 410-296-7631
Mailing address:
  • Phone: 410-371-2728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number10248
License Number StateMD

VIII. Authorized Official

Name: BETH M KATZ
Title or Position: OWNER
Credential: LCSW-C
Phone: 410-371-2728