Healthcare Provider Details

I. General information

NPI: 1679299002
Provider Name (Legal Business Name): JENA JOZWICKI LPC, RPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18205 N 51ST AVE STE 131
GLENDALE AZ
85308-1492
US

IV. Provider business mailing address

1905 E UNIVERSITY DR UNIT 169
TEMPE AZ
85288-4676
US

V. Phone/Fax

Practice location:
  • Phone: 602-499-5329
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number23716
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: