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General NPI Number Information
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NPI Number | 1003421017
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Entity Type | Individual
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Provider Name | MICHAEL KATZ LCSW, CCTP, BHP
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Gender | Male
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 1701 W SAINT MARYS RD STE 117
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City | TUCSON
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State | AZ
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Zip | 85745-2621
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Country | US
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Telephone | 602-545-3714
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Fax |
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Provider Business Mailing Address
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Address Line | 5002 E 1ST ST
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City | TUCSON
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State | AZ
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Zip | 85711-1220
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Country | US
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Telephone | 520-245-7080
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-20779
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LMSW17198
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License Number State | AZ
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