Provider Demographics
NPI:1730517913
Name:ADRIENNE W. KATZOW, PHD, CLINICAL PSYCHOLOGIST, PLLC
Entity type:Organization
Organization Name:ADRIENNE W. KATZOW, PHD, CLINICAL PSYCHOLOGIST, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST (OWNER OF ORG
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:W
Authorized Official - Last Name:KATZOW
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:347-708-6580
Mailing Address - Street 1:113 UNIVERSITY PL
Mailing Address - Street 2:9TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4527
Mailing Address - Country:US
Mailing Address - Phone:347-708-6580
Mailing Address - Fax:
Practice Address - Street 1:113 UNIVERSITY PL
Practice Address - Street 2:9TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4527
Practice Address - Country:US
Practice Address - Phone:347-708-6580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019189-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty