Healthcare Provider Details

I. General information

NPI: 1073655544
Provider Name (Legal Business Name): J&P LOISELLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2292 W. MAGEE RD. SUITE 260
TUCSON AZ
85742-4301
US

IV. Provider business mailing address

2292 W MAGEE RD SUITE 260
TUCSON AZ
85742
US

V. Phone/Fax

Practice location:
  • Phone: 520-797-9306
  • Fax: 520-544-8312
Mailing address:
  • Phone: 520-797-9306
  • Fax: 520-544-8312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLISAC0936
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW0812
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW0813
License Number StateAZ

VIII. Authorized Official

Name: MR. PETER LOISELLE
Title or Position: PRESIDENT
Credential: LCSW LISAC
Phone: 520-797-9306