MEDICARE: KATHLEEN FIELD LAC

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	101YM0800X	Mental Health Counselor	LAC-22945	AZ

General Provider Information

NPI Number	:	1871477653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN FIELD LAC

Provider Business Mailing Address
First Line	:	6232 N 7TH ST STE 208
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-1851
Country	:	US
Telephone Number	:	602-429-9618
Fax Number	:

Provider Business Practice Location Address
First Line	:	6232 N 7TH ST STE 208
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-1851
Country	:	US
Telephone Number	:	602-429-9618
Fax Number	:

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

Provider Enumeration Date	:	08/04/2025
Last Update Date	:	08/04/2025

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Directions to “ KATHLEEN FIELD LAC” Practice Location

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