Active NPI
Jennie Dalcour, LAC
- Counselor
- Phoenix, AZ
National Provider Identifier
1265975239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LAC16280
- Practice address
- 3603 N 7TH Ave
Phoenix, AZ 85013-1024 - Phone
- (602) 287-9125
- NPI assigned
- Nov 23, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LAC16280 | AZ | Primary |
Addresses
Primary practice location
3603 N 7TH Ave
Phoenix, AZ 85013-1024
Mailing address
17333 W Red Bird Rd
Surprise, AZ 85387-1024
Phone (623) 693-0219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAC16280 | AZ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1479859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479859200000",
"number": "1265975239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17333 W RED BIRD RD",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853871024",
"telephone_number": "623-693-0219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3603 N 7TH AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850131024",
"telephone_number": "602-287-9125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALCOUR",
"first_name": "JENNIE",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-23",
"last_updated": "2016-11-23",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AZ",
"license": "LAC16280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.