Provider Demographics
NPI:1801252200
Name:BERGER, HEATHER LYNN (LPC)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:LYNN
Last Name:BERGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1012 S STAPLEY DR
Mailing Address - Street 2:BLD 5 SUITE 117
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85204-4270
Mailing Address - Country:US
Mailing Address - Phone:480-768-6022
Mailing Address - Fax:480-831-0078
Practice Address - Street 1:1855 W BASELINE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-9000
Practice Address - Country:US
Practice Address - Phone:480-831-7563
Practice Address - Fax:480-962-7671
Is Sole Proprietor?:No
Enumeration Date:2016-01-14
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC15808101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional