Provider Demographics
NPI:1811388580
Name:PADGETT, IRIS (LMFT, LPCC)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:PADGETT
Suffix:
Gender:F
Credentials:LMFT, LPCC
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 1427
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-1427
Mailing Address - Country:US
Mailing Address - Phone:707-395-8605
Mailing Address - Fax:
Practice Address - Street 1:518 S SCHOOL ST
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5479
Practice Address - Country:US
Practice Address - Phone:707-463-0405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8732101YP2500X
CA108092106H00000X
CAIMF85011106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional