Healthcare Provider Details

I. General information

NPI: 1447932884
Provider Name (Legal Business Name): JESSICA DAWSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

633 E RAY RD
GILBERT AZ
85296-4200
US

IV. Provider business mailing address

633 E RAY RD
GILBERT AZ
85296-4200
US

V. Phone/Fax

Practice location:
  • Phone: 602-633-4496
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-24330
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: