MEDICARE: MR. JOSEPH SZULCZEWSKI MA, LPC, LISAC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	LISAC1228	AZ
2	101YP2500X	Professional Counselor	LPC11103	AZ

General Provider Information

NPI Number	:	1053300707
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH SZULCZEWSKI MA, LPC, LISAC

Provider Business Mailing Address
First Line	:	18008 N 29TH AVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85053-1709
Country	:	US
Telephone Number	:	602-818-6612
Fax Number	:

Provider Business Practice Location Address
First Line	:	4425 W GLENDALE AVE
Second Line	:	SUITE 2
City	:	GLENDALE
State	:	AZ
Zip	:	85301-2822
Country	:	US
Telephone Number	:	602-818-6612
Fax Number	:

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	09/11/2025

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