Michael Bergstrom, LMFT

Individual provider Active NPI Marriage & Family Therapist · Mesa, AZ

NPI 1225756216 · NPPES record last updated May 12, 2026

Key facts

NPI
1225756216
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LMFT-16517 (AZ)
Practice address
2120 W Guadalupe Rd Ste 6
Mesa, AZ 85202-7366
Phone
(602) 230-7373
Fax
(480) 628-8577
NPI assigned
Aug 16, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3101 N Central Ave
Suite 550
Phoenix, AZ 85012-2635

9494 E Redfield Rd Apt
Suite 2094
Scottsdale, AZ 85260-3767

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260526002749 AZ Practitioner - Marriage and Family Therapist 6204306707 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
LAMFT-10777AZMDMarriage & Family Therapist
LMFT-16517AZMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT-16517 AZ Yes
Marriage & Family Therapist 106H00000X LAMFT-10777 AZ

Addresses

Primary practice location

2120 W Guadalupe Rd Ste 6
Mesa, AZ 85202-7366

Mailing address

3101 N Central Ave Ste 550
Phoenix, AZ 85012-2635
Phone (602) 230-7373

Other providers in Mesa, AZ

All providers in Mesa, AZ · Marriage & Family Therapist in Arizona

Sources for this page

Verify at the official NPI Registry.