MEDICARE: DR. JOSEPH WOODRUFF PHD.

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	175T00000X	Peer Specialist		AZ
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	11731	AZ
3	101YP2500X	Professional Counselor	12894	AZ

General Provider Information

NPI Number	:	1851656813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH WOODRUFF PHD.

Provider Business Mailing Address
First Line	:	2320 W PEORIA AVE STE A105
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4721
Country	:	US
Telephone Number	:	602-541-9660
Fax Number	:

Provider Business Practice Location Address
First Line	:	2320 W PEORIA AVE STE A105
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85029-4721
Country	:	US
Telephone Number	:	602-541-9660
Fax Number	:

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

Provider Enumeration Date	:	07/05/2012
Last Update Date	:	03/18/2026

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