Provider Demographics
NPI:1902446156
Name:SCARBROUGH, HEATHER (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:SCARBROUGH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13260 N 94TH DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4242
Mailing Address - Country:US
Mailing Address - Phone:623-487-7763
Mailing Address - Fax:623-486-8276
Practice Address - Street 1:19820 N 7TH ST STE 140
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85024-1691
Practice Address - Country:US
Practice Address - Phone:623-487-7763
Practice Address - Fax:623-486-8276
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15307106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist