Provider Demographics
NPI:1215799804
Name:BENSON, MATTHEW RUSSELL (LMFT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:RUSSELL
Last Name:BENSON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8737 E VIA DE COMMERCIO STE 200
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-3595
Mailing Address - Country:US
Mailing Address - Phone:480-888-5380
Mailing Address - Fax:
Practice Address - Street 1:8737 E VIA DE COMMERCIO STE 200
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-3595
Practice Address - Country:US
Practice Address - Phone:480-888-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMFT-16013106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist