Individual provider · Type 1 NPI

Gary Jack Peterson, LAC-23090

Counselor · Tucson, AZ

NPI number 1952219982 Active

Practice location

6303 E Tanque Verde Rd Ste 210
Tucson, AZ 85715-3859

Call (520) 423-5600 Map

Fax (520) 423-5600

Mailing address

3732 Barraco Dr
Sierra Vista, AZ 85650-4208

Specialties and licenses

TaxonomyCodeLicense
Counselor Primary 101Y00000XLAC-23090 (AZ)

Counselor: 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.

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About NPI 1952219982

Gary Jack Peterson, LAC-23090's National Provider Identifier is 1952219982, issued on Aug 31, 2026. The primary taxonomy on file is Counselor (101Y00000X), and the practice location is in Tucson, AZ. The record was last updated on Aug 31, 2026.