Provider Demographics
NPI:1548259096
Name:KATZ, JOEL (LCSW)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:
Last Name:KATZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:MR
Other - First Name:JOEL
Other - Middle Name:C
Other - Last Name:KATZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:60 KNOLLS CRES
Mailing Address - Street 2:9D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-6319
Mailing Address - Country:US
Mailing Address - Phone:718-548-8927
Mailing Address - Fax:
Practice Address - Street 1:275 CENTRAL PARK W
Practice Address - Street 2:SUITE 1F, ROOM 4
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3015
Practice Address - Country:US
Practice Address - Phone:212-851-6077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-18
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0228981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN9L811Medicare ID - Type Unspecified