| Kathy Sue Dutridge, LAC | |
|
1540 W Van Buren St, Phoenix, AZ 85007-2414 | |
| (602) 252-7330 | |
| (602) 252-4797 |
| Full Name | Kathy Sue Dutridge |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 1540 W Van Buren St, Phoenix, Arizona |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902202567 | NPI | - | NPPES |
| LAC-13064 | Other | AZ | LAC LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | LPC-16803 (Arizona) | Primary |
| Entity Name | Maricopa County Special Health Care District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073576740 PECOS PAC ID: 4688583651 Enrollment ID: O20031204000823 |
| Mailing Address | Practice Location Address |
|---|---|
| Kathy Sue Dutridge, LAC 202 E Earll Dr, Suite 200, Phoenix, AZ 85012-2647 Ph: (602) 599-5404 | Kathy Sue Dutridge, LAC 1540 W Van Buren St, Phoenix, AZ 85007-2414 Ph: (602) 252-7330 |
Ms. Martha White, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3306 W Catalina Dr, Phoenix, AZ 85017 Phone: 602-353-0703 Fax: 602-353-0715 | |
Philip Lee Mcdonald, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1648 S 16th St, Phoenix, AZ 85034 Phone: 714-235-1970 | |
Melinda Chapin, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 3640 W Osborn Rd, Phoenix, AZ 85019 Phone: 602-269-5300 Fax: 602-269-5380 | |
Beverly Seyler, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 4525 E Saint Anne Ave, Phoenix, AZ 85042 Phone: 602-431-6685 | |
Mrs. Virginia Joyce Gatson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1110 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-685-1940 Fax: 602-685-1944 | |
Margaret Ann Beresford, MC, ATR-BC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4545 N. 36th Street, Suite 117, Phoenix, AZ 85018 Phone: 602-509-5771 | |
Kevin Jessup, LAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 4214 N 19th Pl, Phoenix, AZ 85016 Phone: 602-460-5350 |