Provider Demographics
NPI:1881745230
Name:BERGER, PETER ANDREW (MC LPC LISAC)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:ANDREW
Last Name:BERGER
Suffix:
Gender:M
Credentials:MC LPC LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 W WALTANN LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-3662
Mailing Address - Country:US
Mailing Address - Phone:602-866-2362
Mailing Address - Fax:
Practice Address - Street 1:7101 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-3807
Practice Address - Country:US
Practice Address - Phone:480-429-6292
Practice Address - Fax:480-941-9361
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC0206101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health