Jacquette Shineese Brown

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPC-18852 Issued in AZ

Practice address

1845 S Dobson Rd Ste 211
Mesa, AZ 85202-5663

Phone

(520) 251-1575

Fax

(520) 635-4758

NPI assigned

Mar 13, 2020

Last updated

Aug 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sweet Serenity Behavioral Health and Life Coaching LLC

  • Mental Health Counselor
  • Maricopa, AZ
  • NPI 1336743434
  Authorized official Same address or phone
• Sweet Serenity Behavioral Health and Life Coaching LLC

  • Mental Health Counselor
  • Southfield, MI
  • NPI 1245942275
  NPD
• Helping Associates Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Casa Grande, AZ
  • NPI 1083781959

  Single Specialty

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1013543750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20987 N JOHN WAYNE PKWY # B104-113",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "851392926",
            "telephone_number": "520-251-1575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 S DOBSON RD STE 211",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852025663",
            "telephone_number": "520-251-1575",
            "fax_number": "520-635-4758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1845 S. Dobson Road",
            "address_2": "#211",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "85202",
            "country_code": "US",
            "telephone_number": "520-251-1575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JACQUETTE",
        "middle_name": "SHINEESE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-13",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LPC-18852",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401020212",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra A Brown, PA-C
• Fionnuala S Brown, NP
• Glenn H Brown, M.D.
• Haley Brown
• Ikesha Brown
• Jeana Brown, LPC
• Jill Laurel Brown, LAC
• Joanna Brown, PHARM. D, RPH
• Kimberly Renee Brown, NMD, CAOHC, RN
• Kristy K Brown, ST

• Mental Health Counselor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.