Healthcare Provider Details

I. General information

NPI: 1285824235
Provider Name (Legal Business Name): CELIA SMITH KATZEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2007
Last Update Date: 05/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 SHAD ROW # 1C
PIERMONT NY
10968-3001
US

IV. Provider business mailing address

9 COLONY DR
BLAUVELT NY
10913-1319
US

V. Phone/Fax

Practice location:
  • Phone: 845-365-6306
  • Fax:
Mailing address:
  • Phone: 845-365-3923
  • Fax: 845-365-3331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR039930
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: