Individual provider Active NPI

Dawn R Beatty-Taylor, MC, LPC, CTNC

  • Professional Counselor
  • Mesa, AZ
National Provider Identifier
1750480257
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-10886 Issued in AZ
Practice address
4111 E Valley Auto Dr
Suite 201D
Mesa, AZ 85206-4605
Phone
(480) 775-3528
Fax
(480) 813-2987
NPI assigned
Sep 21, 2006
Last updated
Jan 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 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-10886 AZ Primary

Addresses

Primary practice location

4111 E Valley Auto Dr
Suite 201D
Mesa, AZ 85206-4605

Mailing address

603 N Rosemont Cir
Mesa, AZ 85205-6427
Phone (480) 775-3528

Other practice location 1

603 N Rosemont Cir
Mesa, AZ 85205-6427
Phone (480) 775-3528

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
I20250307001643 AZ Practitioner - Mental Health Counselor 3678094554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
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) 775-3528

603 N Rosemont Cir
Mesa, AZ 85205-6427
Phone (480) 775-3528

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jenis Associates, LLC Professional CurrentSince Jan 21, 2025 Accepting new patients

Locations

4111 E Valley Auto Dr
Ste 201
Mesa, AZ 85206
Phone (480) 608-5250

4111 E Valley Auto Dr
Ste 201D
Mesa, AZ 85206
Phone (480) 775-3528

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, 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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1750480257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 N ROSEMONT CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852056427",
            "telephone_number": "480-775-3528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 E VALLEY AUTO DR",
            "address_2": "SUITE 201D",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064605",
            "telephone_number": "480-775-3528",
            "fax_number": "480-813-2987"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 N Rosemont Cir",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852056427",
            "country_code": "US",
            "telephone_number": "480-775-3528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEATTY-TAYLOR",
        "first_name": "DAWN",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "MC, LPC, CTNC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-10886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.