Provider Demographics
NPI:1417137274
Name:BISSETT, CATHY LYNN (PSYD, MBA)
Entity Type:Individual
Prefix:DR
First Name:CATHY
Middle Name:LYNN
Last Name:BISSETT
Suffix:
Gender:F
Credentials:PSYD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 172
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85139-0049
Mailing Address - Country:US
Mailing Address - Phone:928-274-0294
Mailing Address - Fax:
Practice Address - Street 1:24654 N LAKE PLEASANT PKWY STE 103-497
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85383-1359
Practice Address - Country:US
Practice Address - Phone:928-274-0294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-09
Last Update Date:2015-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3917103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ3917OtherPSYCOLOGICAL LICENSURE