Healthcare Provider Details
I. General information
NPI: 1033039003
Provider Name (Legal Business Name): JUSTIN SZELA LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2033 E WARNER RD
TEMPE AZ
85284-3417
US
IV. Provider business mailing address
101 N 1ST AVE STE 2325
PHOENIX AZ
85003-1933
US
V. Phone/Fax
- Phone: 602-396-8715
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 34012939A |
| License Number State | IN |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LCSW-22249 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: