Provider Demographics
NPI:1679055412
Name:NATALIE WEBBER PLLC
Entity type:Organization
Organization Name:NATALIE WEBBER PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:JO
Authorized Official - Last Name:WEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:928-899-1104
Mailing Address - Street 1:PO BOX 1366
Mailing Address - Street 2:
Mailing Address - City:BAGDAD
Mailing Address - State:AZ
Mailing Address - Zip Code:86321-1366
Mailing Address - Country:US
Mailing Address - Phone:928-243-4198
Mailing Address - Fax:
Practice Address - Street 1:1129 W IRON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-1623
Practice Address - Country:US
Practice Address - Phone:928-899-1104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-17218261QM0850X, 261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health