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Jacquelyn Dearth
Counselor in Parker, Arizona
NPI 1285672212

Jacquelyn Dearth is a Counselor based in Parker, AZ. Jacquelyn Dearth practices in Parker, AZ. The NPI Number for Jacquelyn Dearth is 1285672212 and holds a License No. LISAC-10730 (Arizona).

The current practice location address for Jacquelyn Dearth is 1017 S Laguna Ave, Parker, AZ and can be reached out via phone at 928-669-6906.

Location: 1017 S Laguna Ave, Parker, AZ, 85344-4945
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1285672212
Provider Name
Jacquelyn Dearth
Credential
Provider Entity Type
Individual
Gender
Female
Address
1017 S Laguna Ave, Parker, AZ, 85344-4945
Phone Number
928-669-6906
Fax Number
Provider Enumeration Date
06/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
872722 01 AZ AHCCCS #
institution
Provider Business Practice Location Address Details
Address
1017 S Laguna Ave
City
Parker
State
Arizona
Zip
85344-4945
Phone Number
928-669-6906
Fax Number
person
Provider Business Mailing Address Details
Address
1017 S Laguna Ave
City
Parker
State
Arizona
Zip
85344-4945
Phone Number
928-669-6906
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
LPC-11773 (Arizona)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
LPC-11773 (Arizona)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
LISAC-10730 (Arizona)
Definition
Definition to come...
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