Healthcare Provider Details

I. General information

NPI: 1013959139
Provider Name (Legal Business Name): GERALD THOMAS SZYMANSKI M.A., LPC, LISAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1607 E PLANTATION RD
MOHAVE VALLEY AZ
86440-8420
US

IV. Provider business mailing address

1607 E PLANTATION RD
MOHAVE VALLEY AZ
86440-8420
US

V. Phone/Fax

Practice location:
  • Phone: 928-346-4670
  • Fax: 928-346-4675
Mailing address:
  • Phone: 928-346-4670
  • Fax: 928-346-4675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLISAC-10674
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-11595
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-11595
License Number StateAZ
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPC-10595
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: