Provider Demographics
NPI:1194400895
Name:RAAK, JESSICA LEIGH (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LEIGH
Last Name:RAAK
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1959 S POWER RD STE 103-246
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-3768
Mailing Address - Country:US
Mailing Address - Phone:480-581-5900
Mailing Address - Fax:480-581-5959
Practice Address - Street 1:2200 E WILLIAMS FIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295-0764
Practice Address - Country:US
Practice Address - Phone:480-581-5900
Practice Address - Fax:480-581-5959
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional