KATHY SUE DUTRIDGE LAC
NPI 1902202567
Counselor - Mental Health in Phoenix, AZ

Active since November 10, 2014PECOS EnrolledAccepts Medicare Assignment
1540 W VAN BUREN ST, PHOENIX, AZ 85007(602) 252-7330(602) 252-4797 Get Directions Write a Review

NPPES record last updated: January 9, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kathy Sue Dutridge Lac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATHY SUE DUTRIDGE LAC (NPI 1902202567) is an individual mental health provider in Phoenix, Arizona, licensed in Arizona (LPC-16803) and active in the NPI registry since November 2014. She is enrolled in Medicare PECOS and is a graduate of University Of Arizona College Of Medicine (2007).

NPPES Registry Identity

NPI1902202567
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKATHY SUE DUTRIDGECredential: LAC
Location Address1540 W VAN BUREN STPhoenix, AZ 85007-2414
Mailing Address202 E Earll Dr, Suite 200Phoenix, AZ 85012-2647 · (602) 599-5404 · Fax (602) 599-5704
Fax(602) 252-4797
Sole ProprietorYes
Medical School CMSUniversity Of Arizona College Of MedicineGraduated 2007
Enumeration DateNovember 10, 2014
Last NPPES UpdateJanuary 9, 2024
NPPES CertifiedJanuary 9, 2024
NPI 1902202567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License Licensed in AZ · LPC-16803
1540 W VAN BUREN ST, Phoenix, AZ 85007

Other Identifiers 1

OtherLAC-13064AZ · Lac License

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Kathy Sue Dutridge Lac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406207018
PECOS Enrollment IDI20240108006132
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Case Management
1540 W VAN BUREN ST
PHOENIX, AZ 85007
Clinic/Center (Adult Mental Health)
1540 W VAN BUREN ST
PHOENIX, AZ 85007

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kathy Dutridge's NPI number?

The NPI number for Kathy Dutridge is 1902202567. It was assigned to this individual provider in the NPPES registry on November 10, 2014.

Where is Kathy Dutridge located?

Kathy Dutridge practices at 1540 W Van Buren St, Phoenix, AZ 85007. The listed phone number is (602) 252-7330.

What is Kathy Dutridge's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kathy Dutridge enrolled in Medicare?

Yes. Kathy Dutridge is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kathy Dutridge accept?

Health plans from Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona and Imperial Insurance Companies, Inc. list Kathy Dutridge as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kathy Dutridge was last updated on January 9, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.