Provider Demographics
NPI:1003326638
Name:BERESFORD, MARGARET ANN (MC, ATR-BC, LPC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ANN
Last Name:BERESFORD
Suffix:
Gender:F
Credentials:MC, ATR-BC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4545 N. 36TH STREET
Mailing Address - Street 2:SUITE 117
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-5344
Mailing Address - Country:US
Mailing Address - Phone:602-509-5771
Mailing Address - Fax:
Practice Address - Street 1:4545 N. 36TH STREET, SUITE 117
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-5473
Practice Address - Country:US
Practice Address - Phone:602-509-5771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-10
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-1768101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional