Healthcare Provider Details

I. General information

NPI: 1588191878
Provider Name (Legal Business Name): JESSICA CARTER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1176 E WARNER RD STE 106
GILBERT AZ
85296-3068
US

IV. Provider business mailing address

PO BOX 1886
HIGLEY AZ
85236-1886
US

V. Phone/Fax

Practice location:
  • Phone: 480-269-1413
  • Fax:
Mailing address:
  • Phone: 480-269-1413
  • Fax: 480-907-3717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-18822
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: