Individual provider Active NPI

Jessica L Sisson, LPC

  • Counselor
  • Mesa, AZ
National Provider Identifier
1679090369
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC-16546 Issued in AZ
Practice address
8844 E Pampa Ave
Mesa, AZ 85212-2829
Phone
(480) 358-5532
NPI assigned
Aug 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC-16546 AZ Primary

Addresses

Primary practice location

8844 E Pampa Ave
Mesa, AZ 85212-2829

Mailing address

8844 E Pampa Ave
Mesa, AZ 85212-2829
Phone (480) 358-5532

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
I20240424001781 AZ Practitioner - Mental Health Counselor 1658711650 Receives reassigned benefits from 3 practitioners
Practice locations: Mesa, AZ

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4111 E Valley Auto Dr
Suite 201
Mesa, AZ 85206-4609
Phone (480) 666-5502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Wellness of Arizona PLLC Professional CurrentSince Feb 25, 2024 Accepting new patients

Locations

4111 E Valley Auto Dr
Ste 201
Mesa, AZ 85206
Phone (480) 666-5502

Practitioners & affiliated clinicians

Practitioners 3

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1679090369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8844 E PAMPA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122829",
            "telephone_number": "480-358-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8844 E PAMPA AVE",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852122829",
            "telephone_number": "480-358-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISSON",
        "first_name": "JESSICA",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LPC-16546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.