Provider Demographics
NPI:1851507404
Name:STAFFORD, MARY ESTHER (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:ESTHER
Last Name:STAFFORD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9941 N PLACITA PAPALOTE
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-3650
Mailing Address - Country:US
Mailing Address - Phone:520-575-1497
Mailing Address - Fax:520-575-1497
Practice Address - Street 1:9941 N PLACITA PAPALOTE
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737-3650
Practice Address - Country:US
Practice Address - Phone:520-575-1497
Practice Address - Fax:520-575-1497
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-0692101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional