Provider Demographics
NPI:1881748622
Name:INSTITUTE FOR COGNITIVE BEHAVIORAL THERAPY
Entity type:Organization
Organization Name:INSTITUTE FOR COGNITIVE BEHAVIORAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:WILCOX
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:480-838-4964
Mailing Address - Street 1:4300 N MILLER RD
Mailing Address - Street 2:SUITE 222
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-3619
Mailing Address - Country:US
Mailing Address - Phone:480-838-4964
Mailing Address - Fax:480-767-8803
Practice Address - Street 1:4300 N MILLER RD
Practice Address - Street 2:SUITE 222
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3619
Practice Address - Country:US
Practice Address - Phone:480-838-4964
Practice Address - Fax:480-767-8803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2007-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3752103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty