Provider Demographics
NPI:1730879842
Name:CWIKLINSKI, JANINE VERONICA (LPC)
Entity type:Individual
Prefix:
First Name:JANINE
Middle Name:VERONICA
Last Name:CWIKLINSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6125 E INDIAN SCHOOL RD STE 1005
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-5469
Mailing Address - Country:US
Mailing Address - Phone:480-877-9284
Mailing Address - Fax:
Practice Address - Street 1:1501 YALE STREET
Practice Address - Street 2:BILDG 2 STE.150
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001
Practice Address - Country:US
Practice Address - Phone:928-527-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16576101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor