Jessica A Jacupke, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-19519 Issued in AZ

Practice address

3740 E Southern Ave Ste 209
Mesa, AZ 85206-2512

Phone

(480) 577-7561

NPI assigned

Dec 16, 2018

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 17, 2026 through Feb 17, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Randi Gray Counseling

  • Professional Counselor
  • Mesa, AZ
  • NPI 1013571918
  NPD (past)

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1891266979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 E SOUTHERN AVE STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062512",
            "telephone_number": "480-553-7743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 E SOUTHERN AVE STE 209",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852062512",
            "telephone_number": "480-577-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACUPKE",
        "first_name": "JESSICA",
        "middle_name": "A",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-19519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William M. Jacobs, M.D.
• Diana Lynn Jacobson, R.N.,C.P.N.P.
• William T. Jacoby, M.D.
• Jacqueline Schenkein MD PC
• Rachel Jacquemotte
• Laura Jaenish, LPC, NCC
• Helen Regina Jaffa, M.A. CCC-SLP
• Jaimes Midwifery Services
• Jami Elizabeth Jaimes, M. ED., LISAC
• Pankaj Jain, MD

• Mental Health Counselor in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.