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Active NPI 1851750061 Individual Practitioner Male Practitioner

Sam Jackson , LAC

Counselor • Mesa, AZ

Professional Overview & Biography Verified Profile Summary

Sam Jackson, LAC is a registered healthcare professional specializing in Counselor in Mesa, AZ. Practice services are available at 4250 E FLORIAN AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4250 E Florian Ave
Building #1

Mesa, AZ 852062797

Telephone 4808441653
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Mesa, AZ

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.4 Yrs
State Avg: 13.2 Yrs
Regional Practice Density
118 Specialists

Practicing in Mesa, AZ (1205 Statewide)

Telehealth Adoption Rate
1.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License AZ LAC-15314

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

19 Associated Practitioners
Diane Clodi , LPC

Counselor - Professional

NPI 1063529147

Licensed Professional Counselor

Joseph Plandowski , MA

Student in an Organized Health Care Education/Training Program

NPI 1063608255

Master of Arts

Brett Petersen , LMSW

Social Worker - Clinical

NPI 1063891638

Licensed Master Social Worker

Julie Langanke , BSW

Student in an Organized Health Care Education/Training Program

NPI 1174772511

Bachelor of Social Work

Lawrence Fry , MA, LPC

Counselor - Professional

NPI 1275694861

Master of Arts, Licensed Professional Counselor

Laura Norfor , BHT

Behavior Technician

NPI 1306344908

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active February 16, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location February 16, 2016

Registered at 4250 E FLORIAN AVE, BUILDING #1, MESA, AZ 852062797 (Tel: 4808441653)

📍
Updated Business Mailing Address February 16, 2016

Registered at 924 N COUNTRY CLUB DR, BUILDING #1, MESA, AZ 852014108 (Tel: 4809693800)

👤
Provider Name / Credentials Updated February 16, 2016

Recorded as SAM JACKSON, LAC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 16, 2016

Counselor (License #LAC-15314 in AZ)

🟢
Initial NPI Registration & Enumeration February 16, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1851750061
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 16, 2016
Last Update: February 16, 2016
Sole Proprietor: No

Mailing Address

924 N Country Club Dr, Building #1

Mesa, AZ 852014108

Phone: 4809693800

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.