Active NPI
Kathleen W Cormier, LISAC
- Counselor
- Prescott, AZ
National Provider Identifier
1699757716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LISAC1004
- Practice address
- 625 W Hillside Ave
Ruth Clinic
Prescott, AZ 86301-1936 - Phone
- (928) 445-5211
- Fax
- (928) 776-8484
- NPI assigned
- Nov 15, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LISAC1004 | AZ | Primary |
Addresses
Primary practice location
625 W Hillside Ave
Ruth Clinic
Prescott, AZ 86301-1936
Mailing address
642 Dameron Dr
Prescott, AZ 86301-2411
Phone (928) 445-5211
Other names 1
- Kathleen K Wood
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LISAC1004 | AZ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132012800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1699757716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "642 DAMERON DR",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863012411",
"telephone_number": "928-445-5211",
"fax_number": "928-776-8484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "625 W HILLSIDE AVE",
"address_2": "RUTH CLINIC",
"city": "PRESCOTT",
"state": "AZ",
"postal_code": "863011936",
"telephone_number": "928-445-5211",
"fax_number": "928-776-8484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CORMIER",
"first_name": "KATHLEEN",
"middle_name": "W",
"credential": "LISAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-15",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AZ",
"license": "LISAC1004",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KATHLEEN",
"last_name": "WOOD",
"middle_name": "K",
"credential": "LPC",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Prescott, AZ
- George Mark Coram, RD
- Lucy Helen Corey, LMT NCTM
- Camille Corio, LPC
- Kelley Brooke Corl, NP-C
- Linda Corlett, MS, CCC-SLP
- Cornerstone Caregiving West LLC
- Cornerstone Counseling Services of Arizona
- Cornerstone Family Chiropractic Inc
- Cornerstone Recovery Center (Royal Life Centers)
- Diane W. Cornsweet, PH.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.