Jonathan Katz Psyd Llc | |
1335 Gusdorf Rd Ste N Taos NM 87571-5208 | |
(312) 282-7003 | |
Not Available |
Full Name | Jonathan Katz Psyd Llc |
---|---|
Speciality | Psychologist |
Location | 1335 Gusdorf Rd Ste N, Taos, New Mexico |
Authorized Official Name and Position | Jonathan Katz (PRESIDENT) |
Authorized Official Contact | 3122827003 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Jonathan Katz Psyd Llc 1335 Gusdorf Rd Ste N Taos NM 87571-5208 Ph: (312) 282-7003 | Jonathan Katz Psyd Llc 1335 Gusdorf Rd Ste N Taos NM 87571-5208 Ph: (312) 282-7003 |
NPI Number | 1861087686 |
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Provider Enumeration Date | 03/03/2021 |
Last Update Date | 03/03/2021 |
Certification Date | 03/03/2021 |
Medicare PECOS PAC ID | 7113314170 |
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Medicare Enrollment ID | O20220422000509 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861087686 | NPI | - | NPPES |
37689291 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Jonathan D Katz |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1831348762 PECOS PAC ID: 5294122255 Enrollment ID: I20220422000633 |
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