| Orange Tree Psychotherapy | |
|
1440 E Missouri Ave Ste 160 Phoenix AZ 85014-2542 | |
| (602) 878-8142 | |
| (602) 563-8150 |
| Full Name | Orange Tree Psychotherapy |
|---|---|
| Speciality | Counselor |
| Location | 1440 E Missouri Ave Ste 160, Phoenix, Arizona |
| Authorized Official Name and Position | Nicholas Rudgear (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 6025369321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Orange Tree Psychotherapy 1440 E Missouri Ave Ste 160 Phoenix AZ 85014-2542 Ph: (602) 878-8142 | Orange Tree Psychotherapy 1440 E Missouri Ave Ste 160 Phoenix AZ 85014-2542 Ph: (602) 878-8142 |
| NPI Number | 1962287508 |
|---|---|
| Provider Enumeration Date | 08/30/2023 |
| Last Update Date | 03/22/2026 |
| Certification Date | 03/22/2026 |
| Medicare PECOS PAC ID | 7911482476 |
|---|---|
| Medicare Enrollment ID | O20260401003722 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962287508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| Provider Name | Caitlin Blye Rudgear |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1245974450 PECOS PAC ID: 4284119744 Enrollment ID: I20260402003831 |
| Provider Name | Nicholas Fraser Rudgear |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407329048 PECOS PAC ID: 3375028830 Enrollment ID: I20260403000953 |
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