Irina Katz

Individual provider Active NPI Counselor · North Potomac, MD

NPI 1154814705 · NPPES record last updated Jan 17, 2023

Key facts

NPI
1154814705
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
License
LC50081682 (DC)
Practice address
11504 Piney Lodge Rd
North Potomac, MD 20878-2444
Phone
(202) 854-9812
NPI assigned
Jun 8, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LC50081682DCMDCounselor
149020587ILMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149020587 IL
Counselor 101Y00000X LC50081682 DC Yes

Addresses

Primary practice location

11504 Piney Lodge Rd
North Potomac, MD 20878-2444

Mailing address

11504 Piney Lodge Rd
North Potomac, MD 20878
Phone (202) 854-9812

Other providers in North Potomac, MD

All providers in North Potomac, MD · Counselor in Maryland

Sources for this page

Verify at the official NPI Registry.