Jessica Leigh Raak, PHD, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

2200 E Williams Field Rd Ste 200
Gilbert, AZ 85295-0764

Phone

(480) 581-5900

Fax

(480) 581-5959

NPI assigned

Jun 20, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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

• Kona Counseling PC

  • Professional Counselor
  • Gilbert, AZ
  • NPI 1518577535
  NPD

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1194400895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 S POWER RD STE 103-246",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063768",
            "telephone_number": "480-581-5900",
            "fax_number": "480-581-5959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 E WILLIAMS FIELD RD STE 200",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852950764",
            "telephone_number": "480-581-5900",
            "fax_number": "480-581-5959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAAK",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "PHD, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.