Organization Active NPI

Katz Counseling and Educational Psychology

  • Psychologist
  • Fort Myers, FL
National Provider Identifier
1790065043
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
KATZ COUNSELING AND EDUCATIONAL PSYCHOLOGY
Practice address
12641 World Plaza Lane
BLDG #56
Fort Myers, FL 33907-3990
Phone
(239) 247-1756
Fax
(239) 690-2438
NPI assigned
Aug 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Nolan Heywood Katz, PHDNPI 1356633671
Title
Vice President
Phone
(239) 247-1756

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X
School PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TS0200X

Addresses

Primary practice location

12641 World Plaza Lane
BLDG #56
Fort Myers, FL 33907-3990

Mailing address

12641 World Plaza Lane
BLDG #56
Fort Myers, FL 33907-3990
Phone (239) 247-1756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110823000246 FL Part B Supplier - Clinic/Group Practice 7315117736 Receives reassigned benefits from 2 practitioners
Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

12641 World Plaza Ln
Bldg 56
Fort Myers, FL 33907
Phone (239) 247-1756

12791 World Plaza Ln
#89
Fort Myers, FL 33907
Phone (239) 247-1756

12791 World Plaza Ln
Bldg 56
Fort Myers, FL 33907

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573171200000",
    "number": "1790065043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12641 WORLD PLAZA LANE",
            "address_2": "BLDG #56",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073990",
            "telephone_number": "239-247-1756",
            "fax_number": "239-690-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12641 WORLD PLAZA LANE",
            "address_2": "BLDG #56",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073990",
            "telephone_number": "239-247-1756",
            "fax_number": "239-690-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATZ COUNSELING AND EDUCATIONAL PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-18",
        "last_updated": "2019-11-08",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "NOLAN",
        "authorized_official_middle_name": "HEYWOOD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "239-247-1756",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.