Individual provider Active NPI

Jenna Joann- Mae Robertson

  • Professional Counselor
  • Queen Creek, AZ
National Provider Identifier
1154117372
Registry record updated Jul 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-24023 Issued in AZ
Practice address
20185 E Ocotillo Rd Ste 102
Queen Creek, AZ 85142-7663
Phone
(480) 927-3632
NPI assigned
Apr 15, 2025
Last updated
Jul 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LAC-19124 AZ
Professional Counselor 101YP2500X LPC-24023 AZ Primary

Addresses

Primary practice location

20185 E Ocotillo Rd Ste 102
Queen Creek, AZ 85142-7663

Mailing address

5980 S Cooper Rd Ste 3
Chandler, AZ 85249-5394

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250812002395 AZ Practitioner - Mental Health Counselor 6709384407 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paper Cranes Healthcare LLCGroup PAC ID 2668769589, 8 clinicians

Practice addresses (Care Compare)

5980 S Cooper Rd
Suite 1
Chandler, AZ 85249-5394
Phone (480) 704-3474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LAC-19124AZMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Paper Cranes Healthcare LLC CurrentSince Jun 1, 2025 Accepting new patients
Cranes for Change Corp Mental Health CurrentSince Jun 1, 2025 Accepting new patients

Locations

5980 S Cooper Rd
Ste 1
Chandler, AZ 85249
Phone (480) 704-3474

5980 S Cooper Rd
Ste 3
Chandler, AZ 85249
Phone (480) 597-6448

5980 S Cooper Rd
Ste 4
Chandler, AZ 85249
Phone (480) 927-3813

20185 E Ocotillo Rd
Ste 104
Queen Creek, AZ 85142
Phone (480) 888-2010

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1744675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753747200000",
    "number": "1154117372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5980 S COOPER RD STE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852495394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20185 E OCOTILLO RD STE 102",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851427663",
            "telephone_number": "480-927-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JENNA",
        "middle_name": "JOANN- MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-15",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-19124",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-24023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.