Jennifer L Flack, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-17212 Issued in AZ

Practice address

PO Box 14102
Phoenix, AZ 85063-4102

Phone

(623) 293-2232

Fax

(623) 321-9524

NPI assigned

Feb 9, 2017

Last updated

Sep 24, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Obsidian Health and Wellness LLC

  • Adult Mental Health Clinic/Center
  • Litchfield Park, AZ
  • NPI 1417593575
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1486598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1760920789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850634102",
            "telephone_number": "623-293-2232",
            "fax_number": "623-321-9524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 14102",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850634102",
            "telephone_number": "623-293-2232",
            "fax_number": "623-321-9524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLACK",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-09",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LCSW-17212",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-17212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fixxd Beauty Bundles (Fixxd Beauty RX)
• FJCM Behavioral Health Care LLC
• FJCM Behavioral Healthcare (FJCM Group LLC)
• FKL Enterprises, LLC (reVIBE Mental Health)
• FKL Enterprises, LLC (reVIBE Mental Health)
• Flagstone Healthcare II, LLC (Home Care Resources)
• Amber L Flaherty, M.D.
• Julia Flaherty, LPN
• Matthew Robert Flaherty, MD
• Emily Flake, LPC

• Clinical Social Worker in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.