Provider Demographics
NPI:1255135281
Name:DION, JAIME ALYCE (LAC)
Entity type:Individual
Prefix:MS
First Name:JAIME
Middle Name:ALYCE
Last Name:DION
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4001 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2060
Mailing Address - Country:US
Mailing Address - Phone:623-432-8066
Mailing Address - Fax:
Practice Address - Street 1:4001 N 3RD ST STE 400
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2083
Practice Address - Country:US
Practice Address - Phone:623-432-8066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-23215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health