Individual provider Active NPI

Michael David Katz, PH.D.

  • Psychologist
  • Raleigh, NC
National Provider Identifier
1902879489
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
768 Issued in NC
Practice address
4816 Six Forks Rd
Ste. 104
Raleigh, NC 27609-5250
Phone
(919) 781-0852
Fax
(919) 781-1589
NPI assigned
Feb 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 768 NC Primary

Addresses

Primary practice location

4816 Six Forks Rd
Ste. 104
Raleigh, NC 27609-5250

Mailing address

4816 Six Forks Rd
Ste. 104
Raleigh, NC 27609-5250
Phone (919) 781-0852

Other identifiers 1

IdentifierTypeStateIssuer
04017OtherNCBLUE CROSS BLUE SHIELD-NC

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
0768NCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902879489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4816 SIX FORKS RD",
            "address_2": "STE. 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095250",
            "telephone_number": "919-781-0852",
            "fax_number": "919-781-1589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4816 SIX FORKS RD",
            "address_2": "STE. 104",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276095250",
            "telephone_number": "919-781-0852",
            "fax_number": "919-781-1589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATZ",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD-NC",
            "identifier": "04017",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.