Jessica Taylor Andreychuk

Individual provider Active NPI Professional Counselor · Phoenix, AZ

NPI 1336868652 · NPPES record last updated Nov 7, 2025

Key facts

NPI
1336868652
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC-24083 (AZ)
Practice address
3420 E Shea Blvd Ste 200
Phoenix, AZ 85028-3348
Phone
(480) 500-9284
NPI assigned
Aug 22, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 5

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LPC-24083AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeline Professional Counseling Services, Inc Past Accepting new patients
Lifeline Professional Counseling Services, Inc Counselor Past Accepting new patients
Lifeline Professional Counseling Services, Inc Past Accepting new patients
Lifeline Professional Counseling Services, Inc Past Accepting new patients
Lifeline Professional Counseling Services, Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-24083 AZ Yes

Addresses

Primary practice location

3420 E Shea Blvd Ste 200
Phoenix, AZ 85028-3348

Mailing address

3420 E Shea Blvd Ste 200
Phoenix, AZ 85028-3348

Other names

  • Jesse Taylor Andreychuk Other name

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address jesse@rootedserenityco.com Direct

Other providers in Phoenix, AZ

All providers in Phoenix, AZ · Professional Counselor in Arizona

Sources for this page

Verify at the official NPI Registry.