Provider Demographics
NPI:1366077851
Name:WILLIAM COUTHRAN, PSYD, PLLC
Entity type:Organization
Organization Name:WILLIAM COUTHRAN, PSYD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:W
Authorized Official - Last Name:COUTHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:520-442-2458
Mailing Address - Street 1:3420 N GREEN GULCH CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-7104
Mailing Address - Country:US
Mailing Address - Phone:524-422-2458
Mailing Address - Fax:520-253-8522
Practice Address - Street 1:6700 N ORACLE RD STE 326
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7739
Practice Address - Country:US
Practice Address - Phone:520-442-2458
Practice Address - Fax:520-253-8522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty