MEDICARE: BRENDAN BEGGS M.S., LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LC 1621	AZ

General Provider Information

NPI Number	:	1144478835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDAN BEGGS M.S., LPC

Provider Business Mailing Address
First Line	:	1150 N. COUNTRY CLUB DR.
Second Line	:	SUITE #6
City	:	MESA
State	:	AZ
Zip	:	85201
Country	:	US
Telephone Number	:	480-854-0282
Fax Number	:	480-429-1128

Provider Business Practice Location Address
First Line	:	1150 N COUNTRY CLUB DR
Second Line	:	SUITE #6
City	:	MESA
State	:	AZ
Zip	:	85201-2537
Country	:	US
Telephone Number	:	480-854-0282
Fax Number	:	480-429-1128

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2008
Last Update Date	:	09/05/2008

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