MEDICARE: MRS. KATTYA KOENIGSBERG M.A., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	37PC00031700	NJ

General Provider Information

NPI Number	:	1891834933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATTYA KOENIGSBERG M.A., LPC

Provider Business Mailing Address
First Line	:	8 STRAWBERRY LN
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-5954
Country	:	US
Telephone Number	:	973-984-2127
Fax Number	:	973-889-9080

Provider Business Practice Location Address
First Line	:	155 COUNTY RD
Second Line	:
City	:	CRESSKILL
State	:	NJ
Zip	:	07626-2200
Country	:	US
Telephone Number	:	973-885-8453
Fax Number	:	973-889-9080

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2007
Last Update Date	:	07/08/2007

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