JACKIE POWELL (NPI# 1366895427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366895427 |
| Entity Type | Individual |
| Full Name | JACKIE POWELL |
| Credential | MAC, LISAC |
| Practice Address |
6262 E Broadway Rd Suite 101 Mesa AZ 85206-6101 |
| Practice Telephone | 4806644053 |
| Practice Fax Number | 4804520883 |
| Mailing Telephone | 4806644053 |
| Mailing Fax Number | 4804520883 |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2018-09-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LISAC-15108 | AZ | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194834390 | Jackie Denese Powell | Counselor | 1200 S Acadian Thruway, Baton Rouge, LA 70806-6900 | 2006-08-30 |
| 1376828004 | Jackie Rae Powell | Social Worker | Rr 1 Box 131c, Eufaula, OK 74432-9223 | 2011-10-13 |
| Street Address |
6262 E BROADWAY RD SUITE 101 |
| City | MESA |
| State | AZ |
| Zip Code | 85206-6101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780682666 | Robert J Scharber | Audiologist | 6262 E Broadway Rd, #103, Mesa, AZ 85206-6101 | 2005-07-13 |
| 1538688841 | Danielle N Olin | Counselor | 6262 E Broadway Rd, Mesa, AZ 85206-6101 | 2017-09-18 |
| 1548707839 | Christina Kennedy | Marriage & Family Therapist | 6262 E Broadway Rd, Mesa, AZ 85206-6101 | 2017-01-24 |
| 1235580713 | David Emenhiser | Counselor | 6262 E Broadway Rd, Suite 101, Mesa, AZ 85206-6101 | 2016-06-27 |
| 1336590942 | Lisa Ulibarri | Counselor | 6262 E Broadway Rd, Mesa, AZ 85206-6101 | 2016-06-24 |
| 1144670951 | Soba Mesa LLC | Clinic/Center | 6262 E Broadway Rd, Mesa, AZ 85206-6101 | 2016-06-13 |
| 1578880720 | John Gossett | Social Worker | 6262 E Broadway Rd, Mesa, AZ 85206-6101 | 2010-04-28 |
| 1215083506 | The Retina Group, Pllc | Ophthalmology | 6262 E Broadway Rd, Ste 106, Mesa, AZ 85206-6101 | 2007-01-27 |
| 1689648875 | Alyssa Kim | Ophthalmology | 6262 E Broadway Rd, Suite 106, Mesa, AZ 85206-6101 | 2006-02-14 |
| 1598763484 | East Valley Hearing Center Inc | Audiologist | 6262 E Broadway Rd, #103, Mesa, AZ 85206-6101 | 2005-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720693062 | Inner Balance Counseling LLC | Counselor | 4111 E Auto Valley Drive, Suite 101, Mesa, AZ 85206 | 2020-09-14 |
| 1356978969 | Choices 4 Change Counseling and Coaching LLC | Social Worker | 3707 E Southern Ave., Suite 2027, Mesa, AZ 85206 | 2020-03-24 |
| 1023651288 | Jason Mcclure | Hearing Instrument Specialist | 5540 E Broadway Rd., Mesa, AZ 85206 | 2019-10-21 |
| 1255995361 | Vhs of Phoenix Inc | General Acute Care Hospital | 5750 E. Baseline Rd., Mesa, AZ 85206 | 2019-04-24 |
| 1932682184 | Adam Fishel Frose | Psychologist | 4555 E Inverness Ave Ste 112, Mesa, AZ 85206 | 2018-09-13 |
| 1376024737 | Robyn Kathleen Hall | Psychologist | 4115 East Valley Auto Drive, Suite 208, Mesa, AZ 85206 | 2018-08-23 |
| 1790264984 | Perspective Health, LLC | Clinic/Center | 1959 S. Power Rd, Suite 103, #206, Mesa, AZ 85206 | 2018-08-09 |
| 1033605159 | Rebecca Ann Maro | Nurse Practitioner | 6750 E Baywood Ave Ste 502, Mesa, AZ 85206 | 2018-07-02 |
| 1982195624 | Spark Performance and Physiotherapy | Clinic/Center | 6056 East Basline Road, Suite 147, Mesa, AZ 85206 | 2018-05-29 |
| 1336645993 | Ashley Wright | Audiologist-Hearing Aid Fitter | 1423 S Higley Rd Ste 119, Mesa, AZ 85206 | 2018-04-03 |
| Find all providers in zip 85206 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932725504 | Cheryl Hawley | Counselor | 2727 S Sawyer Cir, Mesa, AZ 85209-6257 | 2020-06-19 |
| 1578192357 | Katherine Desio-scott | Counselor | 9860 E Escondido Ave, Mesa, AZ 85208-3129 | 2020-04-03 |
| 1821639642 | Arizona Intergrated Tele Psychiatry and Tele Medicine Services LLC | Counselor | 2735 E Main St Ste 3, Mesa, AZ 85213-9269 | 2019-10-02 |
| 1881253961 | Amy Massey | Counselor | 522 W Edgewood Ave, Mesa, AZ 85210-3509 | 2019-06-11 |
| 1538630009 | Community Medical Services Arizona-private, LLC | Counselor | 2940 E Main St, Mesa, AZ 85213-9305 | 2018-12-10 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1780137729 | Maxine Mandell | Counselor | 3130 E Caballero St, Mesa, AZ 85213-7902 | 2016-07-26 |
| 1457726036 | Laura Fontaine | Counselor | 2345 S Alma School Rd Ste 105, Mesa, AZ 85210-4013 | 2015-12-07 |
| 1144625765 | Elevate Arizona | Counselor | 3208 N Ladera Cir, Mesa, AZ 85207-0810 | 2014-10-24 |
| 1013311356 | Chad H Close | Counselor | 650 W. Southern Ave., Mesa, AZ 85210 | 2014-10-15 |
| Find all providers in MESA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.