Active NPI
Unlocked Self Counseling PLLC
- Mental Health Counselor
- Mesa, AZ
National Provider Identifier
1417868795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- UNLOCKED SELF COUNSELING PLLC
- Practice address
- 4115 E Valley Auto Dr Ste 104
Mesa, AZ 85206-4610 - Phone
- (623) 216-7320
- NPI assigned
- Sep 15, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jeremy Gwizdalski, LPC
- Title
- Owner
- Phone
- (623) 216-7320
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
4115 E Valley Auto Dr Ste 104
Mesa, AZ 85206-4610
Mailing address
4115 E Valley Auto Dr Ste 104
Suite 104
Mesa, AZ 85206-4610
Phone (623) 216-7320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1789430400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1789948800000",
"number": "1417868795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4115 E VALLEY AUTO DR STE 104",
"address_2": "SUITE 104",
"city": "MESA",
"state": "AZ",
"postal_code": "852064610",
"telephone_number": "623-216-7320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4115 E VALLEY AUTO DR STE 104",
"city": "MESA",
"state": "AZ",
"postal_code": "852064610",
"telephone_number": "623-216-7320"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNLOCKED SELF COUNSELING PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-15",
"last_updated": "2026-09-21",
"certification_date": "2026-09-21",
"status": "A",
"authorized_official_last_name": "GWIZDALSKI",
"authorized_official_first_name": "JEREMY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "623-216-7320",
"authorized_official_credential": "LPC"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.