KEVIN JESSUP LAC NPI 1003328865

NPI Information

NPI: 1003328865
Provider Name: KEVIN JESSUP, LAC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
4214 N 19TH PL
PHOENIX, AZ
ZIP 85016
Phone: (602) 460-5350
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Kevin Jessup, LAC is a mental health counselor in Phoenix, AZ. Kevin Jessup, LAC NPI is 1003328865. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4214 N 19TH PL
PHOENIX, AZ
ZIP 85016-427
Phone: (602) 460-5350

The enumeration date for this NPI number is 11/1/2017 and was last updated on 11/1/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	LAC-14006	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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