MEDICARE: DR. WILLIAM COUTHRAN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY33952	CA
2	103TC0700X	Clinical Psychologist	PY61477123	WA
3	103TC0700X	Clinical Psychologist	PSY-005020	AZ

General Provider Information

NPI Number	:	1053717884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM COUTHRAN PSYD

Provider Business Mailing Address
First Line	:	6700 N ORACLE RD STE 411
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-7734
Country	:	US
Telephone Number	:	520-442-2458
Fax Number	:	520-253-8522

Provider Business Practice Location Address
First Line	:	6700 N ORACLE RD STE 411
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-7734
Country	:	US
Telephone Number	:	520-442-2458
Fax Number	:	520-253-8522

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2014
Last Update Date	:	04/13/2026

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