| 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 |
|---|---|
| Provider Enumeration Date | 03/03/2021 |
| Last Update Date | 03/03/2021 |
| Certification Date | 03/03/2021 |
| Medicare PECOS PAC ID | 7113314170 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831348762 PECOS PAC ID: 5294122255 Enrollment ID: I20220422000633 |
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