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NPI Code Detail

MEDICARE: JESSICA L HERSHEL

MEDICARE:   JESSICA L HERSHEL
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
1101YM0800XMental Health Counselor

Other Identifiers

General Provider Information

NPI Number : 1548517964
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA L HERSHEL
Provider Business Mailing Address
First Line : 3201 W PEORIA AVE STE A200
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4699
Country : US
Telephone Number : 602-525-2018
Fax Number : 602-926-2238
Provider Business Practice Location Address
First Line : 3201 W PEORIA AVE STE A200
Second Line :
City : PHOENIX
State : AZ
Zip : 85029-4699
Country : US
Telephone Number : 602-525-2018
Fax Number : 602-926-2238
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2012
Last Update Date : 09/17/2025

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