Jacqueline E Nash, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-20950 Issued in AZ

Practice address

4646 E Greenway Rd Ste 100
Phoenix, AZ 85032-4805

Phone

(602) 786-5742

NPI assigned

May 25, 2022

Last updated

Nov 14, 2023By the provider in NPPES

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

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

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

FKL Enterprises LLCGroup PAC ID 2961872205, 15 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• FKL Enterprises, LLC

  dba reVIBE Mental Health

  • Marriage & Family Therapist
  • Scottsdale, AZ
  • NPI 1346982782
  Medicare reassignment Care Compare group NPD
• FKL Enterprises, LLC

  dba reVIBE Mental Health

  • Marriage & Family Therapist
  • Phoenix, AZ
  • NPI 1316796790
  NPD

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

{
    "created_epoch": "1653436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1659019933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4646 E GREENWAY RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324805",
            "telephone_number": "602-786-5742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4646 E GREENWAY RD STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850324805",
            "telephone_number": "602-786-5742"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 E Via De Ventura Ste 280",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852584541",
            "country_code": "US",
            "telephone_number": "480-210-7266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NASH",
        "first_name": "JACQUELINE",
        "middle_name": "E",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-25",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-20950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aasya Nasar, PHARMD
• Jalen Naseman, M.S.
• Mohamed H Naser
• Tera Naset, MS, RD
• Elizabeth Rachel Nash
• Laurie A Nash, COTA
• Ajna Nasic
• Bishawy N Nasim
• Nana Aisha Aisha Nasir-Deen, FNP-C
• Diane L. Naslund

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.