Healthcare Provider Details

I. General information

NPI: 1588288740
Provider Name (Legal Business Name): KARI LEE HESKETH LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3048 E BASELINE RD STE 107
MESA AZ
85204-7287
US

IV. Provider business mailing address

3048 E BASELINE RD STE 107
MESA AZ
85204-7287
US

V. Phone/Fax

Practice location:
  • Phone: 480-466-0647
  • Fax:
Mailing address:
  • Phone: 480-717-1739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-21735
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: