Provider Demographics
NPI:1679004667
Name:ALDRIDGE, SARAH (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:
Last Name:ALDRIDGE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 E CAMELBACK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4165
Mailing Address - Country:US
Mailing Address - Phone:602-636-5705
Mailing Address - Fax:602-563-6570
Practice Address - Street 1:7600 N 15TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020
Practice Address - Country:US
Practice Address - Phone:602-563-6570
Practice Address - Fax:602-563-6575
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-22
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002692A103TC0700X
AZ4796103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ256137Medicaid