Provider Demographics
NPI:1386081156
Name:LECIEJEWSKI, DEBRA A (LPC, LISAC)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:A
Last Name:LECIEJEWSKI
Suffix:
Gender:F
Credentials:LPC, LISAC
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:A
Other - Last Name:NOSKOVIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3003 N CENTRAL AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2929
Mailing Address - Country:US
Mailing Address - Phone:602-685-6000
Mailing Address - Fax:602-302-7925
Practice Address - Street 1:6151 W OLIVE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-4547
Practice Address - Country:US
Practice Address - Phone:602-685-6000
Practice Address - Fax:602-269-8410
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19718101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health