Jaclyn R Kimmel, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-17563 Issued in AZ

Practice address

2633 E Indian School Rd Ste 250
Phoenix, AZ 85016-0703

Phone

(602) 831-2131

NPI assigned

Sep 23, 2020

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

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Creative Healing Counseling LLC

  • Professional Counselor
  • Tempe, AZ
  • NPI 1801699954
  NPD Authorized official
• Az Therapy LLC

  dba Road to Therapy

  • Clinical Social Worker
  • Phoenix, AZ
  • NPI 1548772684
  NPD

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1922615004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2633 E INDIAN SCHOOL RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160703",
            "telephone_number": "602-831-2131",
            "fax_number": "480-522-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2633 E INDIAN SCHOOL RD STE 250",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850160703",
            "telephone_number": "602-831-2131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 E Highland Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850164833",
            "country_code": "US",
            "telephone_number": "480-712-8201",
            "fax_number": "480-522-1121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMMEL",
        "first_name": "JACLYN",
        "middle_name": "R",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-17563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.authenticjourneyaz.com",
            "affiliation": "N",
            "endpointDescription": "Web Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Web",
            "address_1": "2211 E Highland Ave Ste 100",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850164833",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://roadtotherapy.com/",
            "affiliation": "N",
            "endpointDescription": "Web Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Web",
            "address_1": "2633 E Indian School Rd Ste 250",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850160703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nicholas James Kimel, DC
• Brenda D Kimery, P.A.-C.
• Alecia Kimes, LMSW
• Rachael Ann Kimes, NP
• Kimiko Management, LLC (Comfort Care Dental)
• Bruce James Kimura
• Kinanllc (Kinan Behavioral health)
• Julie Kinback
• Allyssa Nicole Kincade, FNP-C
• Michael L Kincaid, DDS

• 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 Mar 31, 2025; 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.