Individual provider Active NPI

John J Jaksich, LPC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1376130013
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-23944 Issued in AZ
Practice address
460 N Mesa Dr Ste 201
Mesa, AZ 85201-5957
Phone
(480) 838-5550
NPI assigned
Dec 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-23944 AZ Primary

Addresses

Primary practice location

460 N Mesa Dr Ste 201
Mesa, AZ 85201-5957

Mailing address

5236 E Des Moines St
Mesa, AZ 85205-6524
Phone (602) 317-3773

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
I20250820002258 AZ Practitioner - Mental Health Counselor 8527567007 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

1760 E Pecos Rd
Suite 344
Gilbert, AZ 85295-3208
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-23944AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Oct 6, 2025 Accepting new patients
Gilbert Counselors, LLC PastSince Jan 1, 2024 Accepting new patients
Little Colorado Behavioral Health Center Inc. Past Accepting new patients

Locations

809 W Riordan Rd
Ste 202
Flagstaff, AZ 86001

1760 E Pecos Rd
Ste 344
Gilbert, AZ 85295
Phone (480) 613-3817

4801 S Lakeshore Dr
Ste 207
Tempe, AZ 85282
Phone (623) 323-8962

333 E Wetmore Rd
Ste 137
Tucson, AZ 85705
Phone (602) 357-9986

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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, 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": "1609200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1376130013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5236 E DES MOINES ST",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852056524",
            "telephone_number": "602-317-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N MESA DR STE 201",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852015957",
            "telephone_number": "480-838-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKSICH",
        "first_name": "JOHN",
        "middle_name": "J",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-29",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-23944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.