Active NPI
Jenisabel S Pyzikiewicz, LCSW
- Mental Health Counselor
- South Jordan, UT
National Provider Identifier
1205305117
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 11339443-3501
- Practice address
- 10782 S Ozarks Dr
South Jordan, UT 84009-5693 - Phone
- (203) 820-3047
- NPI assigned
- Nov 20, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 097800 | NY | |
| Mental Health Counselor | 101YM0800X | 11339443-3501 | UT | Primary |
Addresses
Primary practice location
10782 S Ozarks Dr
South Jordan, UT 84009-5693
Mailing address
10782 S Ozarks Dr
South Jordan, UT 84009-5693
Phone (203) 820-3047
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | JPH | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11339443-3501 | UT | MD | Mental Health Counselor |
| 097800 | NY | MD | Cardiovascular Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1542672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661472000000",
"number": "1205305117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10782 S OZARKS DR",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840095693",
"telephone_number": "203-820-3047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10782 S OZARKS DR",
"city": "SOUTH JORDAN",
"state": "UT",
"postal_code": "840095693",
"telephone_number": "203-820-3047"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PYZIKIEWICZ",
"first_name": "JENISABEL",
"middle_name": "S",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-20",
"last_updated": "2022-08-26",
"certification_date": "2022-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "097800",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "11339443-3501",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "JPH",
"affiliation": "N",
"endpointDescription": "JPH",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "10782 S Ozarks Dr",
"city": "South Jordan",
"state": "UT",
"country_code": "US",
"postal_code": "840095693",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in South Jordan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.