NPIMap

Organization Active NPI

Gotham Ranch, LLC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1609353077
Registry record updated Dec 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
GOTHAM RANCH, LLC
Practice address
4342 E Edgewood Ave
Mesa, AZ 85206-2646
Phone
(480) 577-5327
NPI assigned
Jul 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2023

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

Authorized official

Name
Jessica Lynn Breznak-Higgins, LPCNPI 1801373279
Title
Owner/Counselor
Phone
(480) 577-5327

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

4342 E Edgewood Ave
Mesa, AZ 85206-2646

Mailing address

4342 E Edgewood Ave
Mesa, AZ 85206-2646
Phone (480) 577-5327

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701475200000",
    "number": "1609353077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4342 E EDGEWOOD AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062646",
            "telephone_number": "480-577-5327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4342 E EDGEWOOD AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062646",
            "telephone_number": "480-577-5327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOTHAM RANCH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-27",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A",
        "authorized_official_last_name": "BREZNAK-HIGGINS",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "480-577-5327",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.