Individual
MR. SCOTT PETERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DBH, LMFT, LISAC
Contact information
Practice address
2204 S DOBSON RD STE 201, MESA, AZ 85202-6457
(480) 371-4516
Mailing address
2204 S DOBSON RD STE 201, MESA, AZ 85202-6457
(480) 371-4516
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-11778
AZ
106H00000X
Marriage & Family Therapist
Primary
LMFT-10277
AZ
Other
Enumeration date
01/09/2014
Last updated
06/24/2022
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