Healthcare Provider Details

I. General information

NPI: 1538781596
Provider Name (Legal Business Name): KATZ COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9890 42ND ST NE
ST MICHAEL MN
55376
US

IV. Provider business mailing address

50 W BROADWAY, STE 333 PMB 357717
SALT LAKE CITY UT
84101-2070
US

V. Phone/Fax

Practice location:
  • Phone: 321-458-5663
  • Fax:
Mailing address:
  • Phone: 321-458-5663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSICA E KATZ
Title or Position: OWNER
Credential: LCMHC, LPC, LMHC
Phone: 321-458-5663