Provider Demographics
NPI:1992219513
Name:BROXSON, JANNA LYNN (DBH, MSW, LCSW)
Entity Type:Individual
Prefix:DR
First Name:JANNA
Middle Name:LYNN
Last Name:BROXSON
Suffix:
Gender:F
Credentials:DBH, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N 12TH ST STE 320
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2858
Mailing Address - Country:US
Mailing Address - Phone:602-521-3600
Mailing Address - Fax:
Practice Address - Street 1:1300 N 12TH ST STE 320
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2858
Practice Address - Country:US
Practice Address - Phone:602-521-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AZLCSW-205011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health