MEDICARE: BRENTON WEJROWSKI LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC-22788	AZ

General Provider Information

NPI Number	:	1619616554
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENTON WEJROWSKI LPC

Provider Business Mailing Address
First Line	:	2210 S MILL AVE STE 7C
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-2153
Country	:	US
Telephone Number	:	480-400-9615
Fax Number	:

Provider Business Practice Location Address
First Line	:	2210 S MILL AVE STE 7C
Second Line	:
City	:	TEMPE
State	:	AZ
Zip	:	85282-2153
Country	:	US
Telephone Number	:	480-400-9615
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2022
Last Update Date	:	04/07/2026

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Directions to “ BRENTON WEJROWSKI LPC” Practice Location

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