Provider Demographics
NPI:1487879276
Name:WESTBELD, KATHRYN MARIE (PHD NCP BCCP LHT)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:MARIE
Last Name:WESTBELD
Suffix:
Gender:F
Credentials:PHD NCP BCCP LHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2126 BLACK CAT LN
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-8613
Mailing Address - Country:US
Mailing Address - Phone:602-989-4630
Mailing Address - Fax:
Practice Address - Street 1:2126 BLACK CAT LN
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277
Practice Address - Country:US
Practice Address - Phone:602-989-4630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ586216Medicaid