Dearth, Jacquelyn

Dearth, Jacquelyn is an individual health care provider with primary practice located at 1017 S Laguna Ave , Parker AZ 85344-4945. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Dearth, Jacquelyn can be contacted via phone (928) 669-6906.

Contact Information

Primary practice address
1017 S Laguna Ave Parker AZ 85344-4945
Phone: (928) 669-6906
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X LISAC-10730 Arizona
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC-11773 Arizona
Behavioral Health & Social Service Providers / Counselor 101Y00000X LPC-11773 Arizona

Profile Details

NPI number 1285672212
LBN Legal business name Dearth, Jacquelyn
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated Jun 2nd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285672212 NPPES
Arizona Other 872722 AHCCCS #

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