Provider Demographics
NPI:1053717884
Name:COUTHRAN, WILLIAM (PSYD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:COUTHRAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6700 N ORACLE RD STE 411
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7734
Mailing Address - Country:US
Mailing Address - Phone:520-442-2458
Mailing Address - Fax:520-253-8522
Practice Address - Street 1:6700 N ORACLE RD STE 411
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7734
Practice Address - Country:US
Practice Address - Phone:520-442-2458
Practice Address - Fax:520-253-8522
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-05
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPCOP892101YM0800X
AZPSY-005020103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health