Healthcare Provider Details

I. General information

NPI: 1891736906
Provider Name (Legal Business Name): BRENDA KATZ LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 MIDDLETON ST
BROOKLYN NY
11206-5415
US

IV. Provider business mailing address

18 MIDDLETON ST
BROOKLYN NY
11206-5415
US

V. Phone/Fax

Practice location:
  • Phone: 718-875-6900
  • Fax: 718-855-4660
Mailing address:
  • Phone: 718-875-6900
  • Fax: 718-855-4660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR042156-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: