Tina M Ciezkowski, L.P.C.M.H

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

Practice address

3751 E Portola Valley Dr
Gilbert, AZ 85297-7876

Phone

(516) 376-1099

NPI assigned

Nov 4, 2021

Last updated

Nov 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1871258871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 E PORTOLA VALLEY DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977876",
            "telephone_number": "516-376-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 E PORTOLA VALLEY DR",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852977876",
            "telephone_number": "516-376-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIEZKOWSKI",
        "first_name": "TINA",
        "middle_name": "M",
        "credential": "L.P.C.M.H",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ginger McGregor Churchill, OTR
• Cynthia Churgin, FNP, CNM
• Brooke Cianfrogna, RBT
• Nicola Palmer Ciarelli, PMHNP
• Troy Ciavaglia, P.T.
• Cigna Health Care of Arizona Inc. (CMG Care Today; CMG Care Today-Gilbert)
• Cigna Health Care of Arizona Inc. (CMG Gilbert Health Care Center, Gilbert Center)
• Cigna Healthcare of Arizona, Inc. (Gilbert Out Patient Surgery)
• Cigna Healthcare of Arizona, Inc. (EVERNORTH Care Group Gilbert Health Center)
• Circle of Support

• Group Psychotherapy Psychologist in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Group Psychotherapy Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2021; 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.